Comparison of Intravenous Ampicillin –sulbactam Plus Nebulized Colistin with Intravenous ...

The purpose of this study was evaluating the efficacy and safety of intravenous (IV) ampicillin–sulbactam plus nebulized colistin in the treatment of Ventilator-Associated Pneumonia (VAP) caused by MDR Acinetobacter (MDRA)in ICU patients as an alternative to IV plus nebulized colistin. In this single-blinded RCT, one group received IV colistin and another group IV ampicillin–sulbactam (16 and 12 patients from total 28 patients, respectively) for 14 days or since clinical response. Both groups received nebulized colistin by mesh nebulizer. There were no statistically significant differences between the 2 groups in baseline characteristics and previous antibiotic therapy. In follow up period, no significant difference was observed between 2 groups in rate of microbiological eradication, clinical signs of VAP improvement, survival rate and length of hospital as well as ICU stays. Although we have found no significant differences in Acute Kidney Injury (AKI) incidence between two groups, comparison of cumulative patient-days with stages 2 and 3 AKI with days with no or stage 1 AKI, according to AKIN criteria, revealed significant difference in IV colistin versus IV ampicillin–sulbactam group (p = 0.013). The results demonstrated that the high dose IV ampicillin–sulbactam plus nebulized colistin regimen has comparable efficacy with IV plus nebulized colistin in the treatment of VAP caused by MDRA,withsensitivity to colistin only, with probably lower inciden...
Source: Iranian Journal of Pharmaceutical Research - Category: Drugs & Pharmacology Source Type: research

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Conclusions. High levels of preexisting MDR bacteria in allografts did not increase early PTP and mortality rates in LTRs. Despite the small and highly selective study population, lung allografts with MDR bacteria may be safely transplanted with appropriate posttransplant antibiotic therapy.
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research
CONCLUSION: S. aureus was the predominant causative agent of nosocomial pneumonia. The most frequent risk factor identified for infection with multidrug-resistant organisms was previous treatment with antibiotics. Multidrug-resistant organisms were present in 45% of documented hospital-acquired pneumonias. In admitted patients with non-intensive care unit acquired pneumonia, the intensive care unit mortality rate was nearly five times higher compared to intensive care unit acquired pneumonia. PMID: 31851883 [PubMed - in process]
Source: Acta Medica Portuguesa - Category: General Medicine Tags: Acta Med Port Source Type: research
We hereby report a case of subclinical community ‐acquiredAcinetobacter pneumonia in association with a mature cystic teratoma masquerading as a lung abscess. A 22 ‐year‐old lady presented with fever and right pleuritic chest pain with chest X‐ray showing a right suprahilar shadow. Her symptoms largely subsided with antibiotic therapy but the shadow remained unresolved. Computerized tomography (CT) scan of thorax showed consolidation over the anterior se gment of the right upper lobe with a hypodense area suspicious of a lung abscess. Fine needle aspirates of the lesion grewAcinetobacter baumannii twice but the sha...
Source: Respirology Case Reports - Category: Respiratory Medicine Authors: Tags: Case Report Source Type: research
The purpose of this study was evaluating the efficacy and safety of intravenous (IV) ampicillin–sulbactam plus nebulized colistin in the treatment of Ventilator-Associated Pneumonia (VAP) caused by MDR Acinetobacter (MDRA)in ICU patients as an alternative to IV plus nebulized colistin. In this single-blinded RCT, one group received IV colistin and another group IV ampicillin–sulbactam (16 and 12 patients from total 28 patients, respectively) for 14 days or since clinical response. Both groups received nebulized colistin by mesh nebulizer. There were no statistically significant differences between the 2 groups ...
Source: Iranian Journal of Pharmaceutical Research - Category: Drugs & Pharmacology Source Type: research
Conclusion: The presence of XDR strains of A. baumannii is considerable significant problem in hospitals. Further, similar genetic clonal identified in them indicated the nosocomial infection origin. Hence, these results are very important for control of nosocomial infection committee in health-care systems. PMID: 31673531 [PubMed]
Source: Biomed Res - Category: Research Authors: Tags: Adv Biomed Res Source Type: research
Conclusions: SOFA score at admission, re-intubation, and history of previous hospitalization were independent predictors of VAP. Antimicrobial therapy for VAP should cover MDR Gram-negative organisms.
Source: Lung India - Category: Respiratory Medicine Authors: Source Type: research
This study was performed in 24 centers between January 06, 2014, and December 02, 2016. The patients were evaluated at time of pneumonia diagnosis, when culture results were available, and at 72  h, at the 7th day, and finally at the 28th day of follow-up. Patients with coexistent infections were excluded and only those with a first VAP episode were enrolled. Logistic regression analysis was performed. A total of 177 patients were included; empiric antimicrobial therapy was appropriate (wh en the patient received at least one antibiotic that the infecting strain was ultimately shown to be susceptible) in only 69 (39%)...
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research
Acinetobacter baumannii is currently considered one of the most problematic nosocomial microorganisms. In the present work the hisF gene from the ATCC 17978 strain and the AbH12O-A2 clinical isolate of A. baumannii was found over-expressed during the course of murine pneumonia infections. The study demonstrated that the A. baumannii ATCC 17978 mutant strain lacking the hisF gene induces a sub-lethal pneumonia infection in mice, while the complemented mutant strain increased its virulence. This histidine auxotroph mutant showed an increase on IL-6 secretion and leukocytes recruitment during infections. Furthermore, data rev...
Source: Frontiers in cellular and infection microbiology - Category: Microbiology Source Type: research
;r SA Abstract Empiric antibiotic therapy with a betalactam is standard of care in febrile neutropenia (FN), and is given to prevent early death. The addition of vancomycin is recommended in certain circumstances but the quality of evidence is low, reflecting the lack of clinical data. In order to characterize the epidemiology of early death and shock in FN, we reviewed all episodes of FN from 2003 to 2017 at University Hospital, Federal University of Rio de Janeiro, and looked at factors associated with shock at first fever and early death (within 3 days from first fever) by univariate and multivariate analyses. ...
Source: Antimicrobial Agents and Chemotherapy - Category: Microbiology Authors: Tags: Antimicrob Agents Chemother Source Type: research
STRESS ULCER PROPHYLAXIS AS A RISK FACTOR FOR TRACHEAL COLONIZATION AND HOSPITAL-ACQUIRED PNEUMONIA IN INTENSIVE CARE PATIENTS: IMPACT ON LATENCY TIME FOR PNEUMONIA. Acta Clin Croat. 2019 Mar;58(1):72-86 Authors: Muzlovič I, Štubljar D Abstract Stress ulcer prophylaxis is associated with bacterial colonization of respiratory tract. The aims of our study were to determine risk factors for trachea colonization (TC), colonization of pharynx (CP) or stomach (CD) and hospital-acquired pneumonia (HAP), and divide the factors into those with high risk and low risk. The study population (ventilated int...
Source: Acta Clinica Croatica - Category: General Medicine Tags: Acta Clin Croat Source Type: research
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