Outcomes of adult patients with multidrug-resistant Acinetobacter baumannii ventilator-associated pneumonia treated with monotherapy versus combination therapy in a tertiary hospital.

Autor: Yee LJKG; Division of Infectious Diseases, Department of Medicine, University of the Philippines - Philippine General Hospital, Taft Avenue, Manila, Philippines. Electronic address: lgyee1@alum.up.edu.ph., Abad CLR; Division of Infectious Diseases, Department of Medicine, University of the Philippines - Philippine General Hospital, Taft Avenue, Manila, Philippines., Cabaluna ITG; Institute of Clinical Epidemiology - Department of Medicine, University of the Philippines Manila- National Institutes of Health, Pedro Gil Street, Manila, Philippines., Lim JA; Division of Infectious Diseases, Department of Medicine, University of the Philippines - Philippine General Hospital, Taft Avenue, Manila, Philippines.
Jazyk: angličtina
Zdroj: Diagnostic microbiology and infectious disease [Diagn Microbiol Infect Dis] 2024 Nov; Vol. 110 (3), pp. 116481. Date of Electronic Publication: 2024 Aug 06.
DOI: 10.1016/j.diagmicrobio.2024.116481
Abstrakt: We compared clinical outcomes of patients who received monotherapy and combination therapy for treatment of MDR A. baumannii VAP. 170 patients were included. Vasopressor use and mortality rate were higher for combination therapy (69.3% versus 28.6%, p=0.024; 67.5% versus 14.3%, p=0.007; respectively). Majority received polymyxin B-based combination therapy, with higher mortality than those without polymyxin B (80.2% versus 19.8%, p=0.043). After adjusting for vasopressor use, monotherapy, dual combination, and triple combination therapy were not associated with mortality (aHR 0.24, 95% CI 0.03 to 1.79, p=0.169; aHR 1.26, 95% CI 0.79 to 2.00, p=0.367; aHR 0.93, 95% CI 0.57 to 1.49, p=0.744; respectively). There was no difference in adverse effects and length of stay between the two groups. Mortality from MDR A. baumannii VAP was high and not associated with monotherapy or combination therapy after adjustment for vasopressor use. Antibiotic regimens other than those containing polymyxin are urgently needed for the treatment of these infections.
Competing Interests: Declaration of competing interest None.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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