Clinical outcomes of tigecycline alone or in combination with other antimicrobial agents for the treatment of patients with healthcare-associated multidrug-resistant Acinetobacter baumannii infections
Journal
European Journal of Clinical Microbiology and Infectious Diseases
Journal Volume
32
Journal Issue
9
Pages
1211-1220
Date Issued
2013
Author(s)
Abstract
Tigecycline (TG) has been shown to be active in vitro against Acinetobacter baumannii, although data on the clinical efficacy of TG alone or in combination for the treatment of infections due to multidrug-resistant A. baumannii (MDRAB) remain limited. The purpose of this study was to investigate the clinical outcomes of patients with healthcare-associated infections (HAIs) caused by MDRAB who were treated with imipenem/cilastatin and sulbactam, and TG alone or in combination with other antibiotics. A total of 386 patients with HAIs caused by MDRAB were retrospectively analyzed and grouped into TG and non-TG groups, depending on whether they received TG treatment. Of the 266 patients in the TG group, 108 were treated with TG alone and 158 were treated with TG in combination with ceftazidime, ceftriaxone, piperacillin/tazobactam, or a carbapenem. All 120 patients in the non-TG group were treated with imipenem/cilastatin and sulbactam. The primary outcome measure was 30-day mortality after TG treatment and the secondary outcome was clinical outcome. There were no significant differences in survival rates between the two groups. However, the rate of unfavorable outcome was significantly lower (p < 0.05) among patients in the TG group than among patients in the non-TG group. The most significant predictor of unfavorable outcome was sepsis, whereas TG treatment and microbial eradication were the most significant predictors of favorable outcomes. Our study represents the largest study of patients with MDRAB infection treated with TG and expands our understanding of the role of TG therapy alone or in combination with other agents for the treatment of HAI caused by MDRAB. ? 2013 Springer-Verlag Berlin Heidelberg.
SDGs
Other Subjects
amikacin; aztreonam; carbapenem; ceftazidime; ceftriaxone; cilastatin plus imipenem; ciprofloxacin; gentamicin; imipenem; levofloxacin; meropenem; penicillin derivative; piperacillin plus tazobactam; sulbactam; tigecycline; Acinetobacter baumannii; Acinetobacter infection; aged; analytical equipment; antibiotic sensitivity; APACHE; article; bacterium identification; controlled study; eradication therapy; female; hospital infection; human; major clinical study; male; medical record review; mortality; multidrug resistance; nonhuman; pathogenesis; priority journal; retrospective study; sepsis; Sequential Organ Failure Assessment Score; survival rate; Taiwan; treatment outcome; university hospital; Acinetobacter baumannii; Acinetobacter Infections; Aged; Anti-Bacterial Agents; Ceftazidime; Ceftriaxone; Cilastatin; Cross Infection; Drug Resistance, Multiple, Bacterial; Drug Therapy, Combination; Female; Humans; Imipenem; Male; Minocycline; Piperacillin; Sulbactam; Treatment Outcome
Type
journal article