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Extensive drug resistant Acinetobacter baumannii: a comparative study between non-colistin based combinations.

Eman Elsayed¹, Mohamed A Elarabi², Dana A Sherif³

¹Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura City, Egypt.

International Journal of Clinical Pharmacy

|November 20, 2019

Summary

The combination of Tigecycline and Ampicillin-Sulbactam effectively treated extensively drug-resistant (XDR) Acinetobacter baumannii infections, showing improved outcomes without increased side effects.

Keywords:

Acinetobacter Antibiotic combinations Antibiotic resistance Colistin Free Egypt MDR

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Published on: January 5, 2024

Area of Science:

Infectious Diseases
Clinical Microbiology
Pharmacology

Background:

Extensively drug-resistant (XDR) Acinetobacter baumannii poses a significant treatment challenge, particularly when last-resort antibiotics like colistin are unavailable.
Egyptian healthcare facilities, like GISC-Mansoura University, have faced XDR A. baumannii outbreaks, necessitating alternative therapeutic strategies.

Purpose of the Study:

To retrospectively evaluate the clinical effectiveness of various antibiotic combinations against XDR A. baumannii.
To identify optimal treatment regimens when standard therapies are ineffective and colistin is inaccessible.

Main Methods:

A retrospective study analyzing clinical data from patients treated at GISC-Mansoura University.
Patients were divided into groups receiving different antibiotic combinations, including Cephalosporin/Fluoroquinolone, Carbapenem/Fluoroquinolone, B-lactam/Aminoglycoside, Carbapenem/Glycylcycline, and Tigecycline/Ampicillin-Sulbactam.
Primary outcomes included microbiological culture negativity at 14 days and 30-day survival; secondary outcomes assessed adverse effects.

Main Results:

The combination of Tigecycline and Ampicillin-Sulbactam demonstrated significantly higher rates of microbiological clearance and survival compared to other regimens.
No significant increase in adverse events was observed in the Tigecycline and Ampicillin-Sulbactam group.
Individual resistance to Tigecycline and Ampicillin-Sulbactam was noted, yet their combination proved effective.

Conclusions:

The combination of Tigecycline and Ampicillin-Sulbactam is a clinically effective therapeutic option for treating XDR A. baumannii infections.
This combination offers a viable alternative in resource-limited settings where colistin is unavailable.
Further prospective studies are warranted to confirm these findings.