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Pharmacotherapy ; 21(2): 142-8, 2001 Feb.
Article in English | MEDLINE | ID: mdl-11213849

ABSTRACT

STUDY OBJECTIVE: To evaluate epidemiology, resistance, and treatment outcomes of Acinetobacter baumannii bacteremia treated with imipenem-cilastatin or ampicillin-sulbactam for 72 hours or longer. DESIGN: Retrospective analysis. SETTING: University teaching hospital. PATIENTS: Forty-eight patients with A. baumannii bacteremia. INTERVENTION: Evaluation of susceptibility and clinical data from 48 patients treated with either ampicillin-sulbactam or imipenem-cilastatin from 1987-1999. MEASUREMENTS AND MAIN RESULTS: Comparing ampicillin-sulbactam and imipenem-cilastatin, there were no differences between days of bacteremia (4 vs 2 days, p=0.05), days to resolution of temperature or white blood cell count, success or failure during or at end of treatment, or intensive care unit total or antibiotic-related length of stay (13 vs 10 days, p=0.05). Patients treated with ampicillin-sulbactam had significantly decreased antibiotic treatment costs (1500 dollars vs 500 dollars, p=0.004). CONCLUSION: Ampicillin-sulbactam is at least as effective as imipenem-cilastatin based on clinical response at days 2, 7, and end of treatment and is a cost-effective alternative for treatment of A. baumannii infections.


Subject(s)
Acinetobacter Infections/drug therapy , Ampicillin/therapeutic use , Bacteremia/drug therapy , Cilastatin/therapeutic use , Drug Therapy, Combination/therapeutic use , Imipenem/therapeutic use , Sulbactam/therapeutic use , Acinetobacter Infections/economics , Acinetobacter Infections/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Ampicillin/economics , Bacteremia/economics , Bacteremia/epidemiology , Chi-Square Distribution , Cilastatin/economics , Cilastatin, Imipenem Drug Combination , Drug Combinations , Drug Resistance, Microbial , Drug Therapy, Combination/economics , Female , Humans , Imipenem/economics , Male , Middle Aged , Retrospective Studies , Statistics, Nonparametric , Sulbactam/economics , Treatment Outcome
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