Related Experiment Videos

Severe nosocomial infections with imipenem-resistant Acinetobacter baumannii treated with ampicillin/sulbactam

Anna S Levin1, Carlos E Levy, A Edison I Manrique

  • 1Nosocomial Infection Control Department, Hospital das Clínicas, University of São Paulo, Rua Harmonia 564/52, São Paulo, SP 05435-000, Brazil. gcih@hcnet.usp.br

International Journal of Antimicrobial Agents
|January 1, 2003
PubMed

Insights

Ampicillin/sulbactam effectively treated severe nosocomial infections caused by multidrug-resistant Acinetobacter baumannii in 67.5% of patients. This antibiotic combination demonstrated a good safety profile, offering a viable therapeutic option for these challenging infections.

Area of Science:

  • Infectious Diseases
  • Clinical Pharmacology
  • Critical Care Medicine

Background:

  • Nosocomial infections caused by multidrug-resistant Acinetobacter baumannii (MDR-AB) pose a significant therapeutic challenge.
  • Acinetobacter baumannii is a common cause of severe hospital-acquired infections, particularly in intensive care units (ICUs).
  • Limited effective treatment options exist for infections caused by MDR-AB.

Purpose of the Study:

  • To evaluate the efficacy and safety of intravenous ampicillin/sulbactam for treating nosocomial infections caused by MDR-AB.
  • To determine the clinical outcomes in patients with severe infections receiving ampicillin/sulbactam therapy.

Main Methods:

  • A consecutive series of 40 patients with nosocomial infections due to MDR-AB were treated with intravenous ampicillin/sulbactam.
  • Infection types included bloodstream, pneumonia, urinary tract, peritonitis, surgical site, meningitis, and sinusitis.
  • Patient severity was assessed using the APACHE II score, with a median score of 14.5.

Main Results:

  • A total of 67.5% of patients showed improvement or were cured.
  • Treatment failure occurred in 17.5% of patients, and 15% had indeterminate outcomes due to early mortality.
  • Two cases of meningitis did not respond to ampicillin/sulbactam.
  • The median daily dose was 6 g/3 g, with some patients receiving up to 12 g/6 g.
  • No adverse effects were observed during the treatment period.

Conclusions:

  • Intravenous ampicillin/sulbactam is a potentially effective and safe therapeutic option for severe nosocomial infections caused by MDR-AB.
  • The study supports the use of ampicillin/sulbactam in settings with limited alternatives for treating MDR-AB infections.
  • Further research may be warranted to explore optimal dosing and specific indications for ampicillin/sulbactam in MDR-AB infections.

Related Concept Videos

Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
Mechanism of Antibiotic Resistance in MRSA01:25

Mechanism of Antibiotic Resistance in MRSA

Antibiotic resistance in bacteria arises when microorganisms evolve the ability to withstand drugs designed to kill them or inhibit their growth, rendering once-effective treatments useless. This phenomenon, driven by genetic change and selection under antibiotic exposure, poses a profound threat to modern medicine. Mechanisms include drug-inactivating enzymes (e.g., β-lactamases), efflux pumps that eject antibiotics, mutations altering antibiotic targets, decreased drug uptake, and acquisition...
Clinical Significance of Antibiotic Resistance01:25

Clinical Significance of Antibiotic Resistance

Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...
Pneumonia I: Introduction01:29

Pneumonia I: Introduction

Pneumonia is an infection of the lower respiratory tract that leads to inflammation of the lung parenchyma, often resulting in the accumulation of inflammatory exudate in the alveoli and airways. Unlike the watery, low-protein fluid exudate in pulmonary edema, the exudate in this case is a thick fluid rich in immune cells, proteins, and debris produced during infection and inflammation.This impairs gas exchange and can lead to consolidation of lung tissue. The infection may be caused by a...
Atypical Pneumonia01:14

Atypical Pneumonia

Atypical pneumonia, often caused by Mycoplasma pneumoniae, is a form of pulmonary infection that differs from the classical presentation of bacterial pneumonia in both its cause and clinical symptoms. Mycoplasma pneumoniae is a pleomorphic bacterium notable for its lack of a rigid cell wall. This structural characteristic imparts resistance to beta-lactam antibiotics and significantly influences the bacterium’s behavior within the human host.Other pathogens responsible for the disease include...
Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such as Proteus,...