Comparison of Two Different Doses of Ampicillin-Sulbactam as Part of Combination Therapy in the Treatment of Multidrug Resistant Acinetobacter baumannii Ventilator Associated Pneumonia: A Randomized Clinical Trial
Abstract
Purpose Ventilator-associated pneumonia (VAP) caused by multidrug-resistant (MDR) Acinetobacter baumannii is associated with high morbidity and mortality, and optimal antimicrobial dosing strategies remain uncertain. Although ampicillin-sulbactam is increasingly used for MDR Acinetobacter baumannii infections, limited clinical data exist regarding the efficacy and safety of different dosing regimens when used as part of combination therapy. This study aimed to compare the clinical outcomes of low- versus high-dose ampicillin-sulbactam in combination of meropenem and colistin in patients with MDR Acinetobacter baumannii associated VAP. Patients and Methods In this randomized clinical trial, patients with MDR Acinetobacter baumannii associated VAP admitted to the intensive care unit were allocated to receive either low-dose ampicillin-sulbactam (6 g IV every 6 h; total 24 g/day) or high-dose ampicillin-sulbactam (9 g IV every 6 h; total 36 g/day). Meropenem and colistin were administered concomitantly in both groups, as they remain commonly used standard therapies for severe MDR infections despite increasing resistance and toxicity concerns. Clinical outcomes, including fever duration, pulmonary secretions, Clinical Pulmonary Infection Score (CPIS), duration of mechanical ventilation, length of ICU and hospital stay, mortality, and adverse drug reactions, were assessed over a 10-day follow-up period. Results A total of 77 patients were enrolled (39 in the low-dose group and 38…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 77 participants or records.
Read the paper
Related studies
- Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching
- Penicillins for Treatment of Pneumococcal Pneumonia: Does In Vitro Resistance Really Matter?
- Thiophenes—Naturally Occurring Plant Metabolites: Biological Activities and In Silico Evaluation of Their Potential as Cathepsin D Inhibitors
- Inhalable Mannosylated Rifampicin–Curcumin Co-Loaded Nanomicelles with Enhanced In Vitro Antimicrobial Efficacy for an Optimized Pulmonary Tuberculosis Therapy
- Development and validation of microbial bioassay for quantification of Levofloxacin in pharmaceutical preparations
- Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.