Pediatr Infect Vaccine.  2020 Apr;27(1):45-52. 10.14776/piv.2020.27.e5.

Outcome of High Dose Ampicillin-Sulbactam and Colistin Combination Therapy for Treating Ventilator-Associated Pneumonia Caused by Carbapenem-Resistant Acinetobacter baumannii: a Pilot Study

Affiliations
  • 1Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, the Republic of Korea
  • 2Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan, the Republic of Korea

Abstract

Purpose
This pilot study aimed to evaluate the efficacy of high dose ampicillin-sulbactam and colistin combination therapy for ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii (CRAB) in the pediatric intensive care unit of Pusan National University Children's Hospital.
Methods
We retrospectively reviewed 17 pediatric patients with VAP caused by CRAB from June 2017 to August 2018. Ten (58.8%) patients were treated with high dose ampicillin-sulbactam and colistin combination therapy (combination therapy group), whereas 7 were treated with colistin only or with various combinations with or without colistin (other antibiotics group). Clinical and bacteriological outcomes were compared between the groups.
Results
The mean duration of fever after antibiotic use was 1.30±1.70 days in the combination therapy group and 1.71±1.49 days in the other antibiotics group. The mean duration of days for negative conversion of endotracheal aspirate bacterial culture after antibiotic therapy was 3.40±1.71 days in the combination therapy group and 11.80±8.86 days in the other antibiotics group. The mortality rate within 30 days of antibiotic therapy was 1/10 (10%) in the combination therapy group and 3/7 (42.9%) in the other antibiotics group.
Conclusions
High dose ampicillin-sulbactam and colistin combination therapy as early antibiotic treatment in VAP caused by CRAB in children could improve clinical outcomes.

Keyword

Acinetobacter baumannii; Carbapenem-resistant; Colistin; Ampicillin-Sulbactam; Ventilator-associated pneumonia; Children
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