Comparison of the efficacies of three empirically-selected antibiotics for treating Acinetobacter baumannii pulmonary infection: experience from a teaching hospital in China

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OBJECTIVE

Infections due to multidrug- and extensively drug-resistant forms of Acinetobacter baumannii (MDR-AB and XDR-AB, respectively) have become increasingly prevalent. This retrospective study compared the outcomes of patients infected with MDR-AB or XDR-AB and treated with one of three antibiotics.

METHODS

Enrolled were patients with MDR-AB or XDR-AB pulmonary infection based on their first sputum culture. Patients were treated empirically with carbapenems (n = 46), tigecycline (n = 25), or cefoperazone/sulbactam (cefina-SB; n = 35). The therapeutic efficacies of the drugs and patient outcomes were retrospectively compared. Bacterial resistance to the three antibacterials was determined based on sputum cultures from all enrolled patients.

RESULTS

The study included 106 patients. After 7 days of treatment, the favorable response rates to tigecycline (60%) and to cefina-SB (71.4%) were statistically similar (p = 0.355) but significantly higher than that to carbapenems (23.9%; p = 0.003 and p < 0.001, respectively). Sputum culture analyses to determine antibiotic susceptibility indicated that 10.4% of patients' sputum cultures were susceptible to carbapenems, 76.4% to tigecycline, and 66.0% to cefina-SB. In addition, 58.5% were susceptible to both tigecycline and cefina-SB.

CONCLUSIONS

Tigecycline and cefina-SB appeared to be more effective against MDR-AB and XDR-AB pulmonary infections than carbapenems, especially for patients who had been admitted to the intensive care unit multiple times.
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