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Clinical Outcomes and Safety of Meropenem–Colistin versus Meropenem–Tigecycline in Patients with Carbapenem-Resistant Acinetobacter baumannii Pneumonia

This study compared the clinical outcomes and safety of meropenem–colistin versus meropenem–tigecycline in the treatment of adult patients with carbapenem-resistant Acinetobacter baumannii (CRAB) pneumonia. A retrospective observational study of patients with CRAB pneumonia was performed at a 1048-b...

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Autores principales: Park, Jae-Min, Yang, Kyung-Sook, Chung, You-Seung, Lee, Ki-Byung, Kim, Jeong-Yeon, Kim, Sun-Bean, Sohn, Jang-Wook, Yoon, Young-Kyung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8388669/
https://www.ncbi.nlm.nih.gov/pubmed/34438953
http://dx.doi.org/10.3390/antibiotics10080903
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author Park, Jae-Min
Yang, Kyung-Sook
Chung, You-Seung
Lee, Ki-Byung
Kim, Jeong-Yeon
Kim, Sun-Bean
Sohn, Jang-Wook
Yoon, Young-Kyung
author_facet Park, Jae-Min
Yang, Kyung-Sook
Chung, You-Seung
Lee, Ki-Byung
Kim, Jeong-Yeon
Kim, Sun-Bean
Sohn, Jang-Wook
Yoon, Young-Kyung
author_sort Park, Jae-Min
collection PubMed
description This study compared the clinical outcomes and safety of meropenem–colistin versus meropenem–tigecycline in the treatment of adult patients with carbapenem-resistant Acinetobacter baumannii (CRAB) pneumonia. A retrospective observational study of patients with CRAB pneumonia was performed at a 1048-bed university-affiliated hospital in the Republic of Korea between June 2013 and January 2020. All adult patients initially treated with meropenem–colistin were compared with those treated with meropenem–tigecycline to evaluate in-hospital mortality and adverse events. Altogether, 66 patients prescribed meropenem–colistin and 24 patients prescribed meropenem–tigecycline were included. All patients had nosocomial pneumonia, and 31.1% had ventilator-associated pneumonia. The minimum inhibitory concentrations of meropenem ≤ 8 μg/mL and tigecycline ≤ 2 μg/mL were 20.0% and 81.1%, respectively. The in-hospital and 28-day mortality rates were 40% and 32%, respectively. In the Cox proportional hazard regression analysis, predictors associated with in-hospital mortality included procalcitonin ≥ 1 ng/mL (adjusted hazard ratio (aHR), 3.39; 95% confidence interval (CI) 1.40–8.19; p = 0.007) and meropenem–colistin combination therapy (aHR, 2.58; 95% CI, 1.07–6.23; p = 0.036). Episodes of nephrotoxicity were significantly more common in the meropenem–colistin group than in the meropenem–tigecycline group (51.5% vs. 12.5%, p = 0.001). Meropenem–tigecycline combination therapy might be a valuable treatment option for patients with CRAB pneumonia.
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spelling pubmed-83886692021-08-27 Clinical Outcomes and Safety of Meropenem–Colistin versus Meropenem–Tigecycline in Patients with Carbapenem-Resistant Acinetobacter baumannii Pneumonia Park, Jae-Min Yang, Kyung-Sook Chung, You-Seung Lee, Ki-Byung Kim, Jeong-Yeon Kim, Sun-Bean Sohn, Jang-Wook Yoon, Young-Kyung Antibiotics (Basel) Article This study compared the clinical outcomes and safety of meropenem–colistin versus meropenem–tigecycline in the treatment of adult patients with carbapenem-resistant Acinetobacter baumannii (CRAB) pneumonia. A retrospective observational study of patients with CRAB pneumonia was performed at a 1048-bed university-affiliated hospital in the Republic of Korea between June 2013 and January 2020. All adult patients initially treated with meropenem–colistin were compared with those treated with meropenem–tigecycline to evaluate in-hospital mortality and adverse events. Altogether, 66 patients prescribed meropenem–colistin and 24 patients prescribed meropenem–tigecycline were included. All patients had nosocomial pneumonia, and 31.1% had ventilator-associated pneumonia. The minimum inhibitory concentrations of meropenem ≤ 8 μg/mL and tigecycline ≤ 2 μg/mL were 20.0% and 81.1%, respectively. The in-hospital and 28-day mortality rates were 40% and 32%, respectively. In the Cox proportional hazard regression analysis, predictors associated with in-hospital mortality included procalcitonin ≥ 1 ng/mL (adjusted hazard ratio (aHR), 3.39; 95% confidence interval (CI) 1.40–8.19; p = 0.007) and meropenem–colistin combination therapy (aHR, 2.58; 95% CI, 1.07–6.23; p = 0.036). Episodes of nephrotoxicity were significantly more common in the meropenem–colistin group than in the meropenem–tigecycline group (51.5% vs. 12.5%, p = 0.001). Meropenem–tigecycline combination therapy might be a valuable treatment option for patients with CRAB pneumonia. MDPI 2021-07-23 /pmc/articles/PMC8388669/ /pubmed/34438953 http://dx.doi.org/10.3390/antibiotics10080903 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Park, Jae-Min
Yang, Kyung-Sook
Chung, You-Seung
Lee, Ki-Byung
Kim, Jeong-Yeon
Kim, Sun-Bean
Sohn, Jang-Wook
Yoon, Young-Kyung
Clinical Outcomes and Safety of Meropenem–Colistin versus Meropenem–Tigecycline in Patients with Carbapenem-Resistant Acinetobacter baumannii Pneumonia
title Clinical Outcomes and Safety of Meropenem–Colistin versus Meropenem–Tigecycline in Patients with Carbapenem-Resistant Acinetobacter baumannii Pneumonia
title_full Clinical Outcomes and Safety of Meropenem–Colistin versus Meropenem–Tigecycline in Patients with Carbapenem-Resistant Acinetobacter baumannii Pneumonia
title_fullStr Clinical Outcomes and Safety of Meropenem–Colistin versus Meropenem–Tigecycline in Patients with Carbapenem-Resistant Acinetobacter baumannii Pneumonia
title_full_unstemmed Clinical Outcomes and Safety of Meropenem–Colistin versus Meropenem–Tigecycline in Patients with Carbapenem-Resistant Acinetobacter baumannii Pneumonia
title_short Clinical Outcomes and Safety of Meropenem–Colistin versus Meropenem–Tigecycline in Patients with Carbapenem-Resistant Acinetobacter baumannii Pneumonia
title_sort clinical outcomes and safety of meropenem–colistin versus meropenem–tigecycline in patients with carbapenem-resistant acinetobacter baumannii pneumonia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8388669/
https://www.ncbi.nlm.nih.gov/pubmed/34438953
http://dx.doi.org/10.3390/antibiotics10080903
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