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Updated: Feb 16, 2026
08:46
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
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Monotherapy versus Combination Therapy against Nonbacteremic Carbapenem-resistant Gram-negative Infections: A
Abdul Ghafur1, Vidyalakshmi Devarajan1, T Raja2
1Department of Infectious Diseases, Apollo Cancer Institute, Chennai, Tamil Nadu, India.
Summary
Colistin-carbapenem combination therapy (CCCT) showed no significant benefit over colistin monotherapy (CMT) for carbapenem-resistant Gram-negative bacterial (CRGNB) nonbacteremic infections. Higher APACHE II scores and Klebsiella infections independently increased mortality risk.
Area of Science:
- Infectious Diseases
- Pharmacology
- Critical Care Medicine
Background:
- Colistin-carbapenem combination therapy (CCCT) is increasingly used for carbapenem-resistant Gram-negative bacterial (CRGNB) infections.
- Evidence supporting CCCT superiority over colistin monotherapy (CMT) remains inconclusive, particularly for nonbacteremic infections.
Purpose of the Study:
- To evaluate the comparative effectiveness of CCCT versus CMT in treating CRGNB nonbacteremic infections.
- To identify risk factors associated with mortality in this patient population.
Main Methods:
- Retrospective observational cohort study involving 153 patients with CRGNB nonbacteremic infections over four years.
- Data collected via medical record review at a tertiary care center in India.
- Statistical analysis included univariate and multivariate Cox regression, with P < 0.05 considered significant.
Main Results:
- CCCT was administered to 92 patients, and CMT to 61 patients.
- Univariate analysis identified higher APACHE II scores, pneumonia, and Klebsiella as risk factors for 28-day mortality.
- Multivariate analysis confirmed higher APACHE II scores and Klebsiella infections as independent predictors of mortality; CCCT showed no significant impact on mortality (OR = 0.91, P = 0.857).
Conclusions:
- In this single-center retrospective study, CCCT did not demonstrate superiority over CMT for CRGNB nonbacteremic infections.
- Larger multicenter observational studies or prospective randomized trials are warranted to definitively establish treatment efficacy.
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