The effectiveness of colistin/levofloxacin compared to colistin/meropenem in the treatment of ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii: a randomized controlled clinical trial
Background and purpose: The treatment of ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii (CRAB) is still a great challenge. This study evaluated the effectiveness of the colistin/levofloxacin regimen compared to the usual colistin/meropenem regimen in the...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
|
| Series: | Research in Pharmaceutical Sciences |
| Subjects: | |
| Online Access: | http://www.rpsjournal.net/article.asp?issn=1735-5362;year=2023;volume=18;issue=1;spage=39;epage=48;aulast=Momenzadeh |
| _version_ | 1828065910676520960 |
|---|---|
| author | Mahnaz Momenzadeh Rasool Soltani Fatemeh Shafiee Atousa Hakamifard Morteza Pourahmad Saeed Abbasi |
| author_facet | Mahnaz Momenzadeh Rasool Soltani Fatemeh Shafiee Atousa Hakamifard Morteza Pourahmad Saeed Abbasi |
| author_sort | Mahnaz Momenzadeh |
| collection | DOAJ |
| description | Background and purpose: The treatment of ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii (CRAB) is still a great challenge. This study evaluated the effectiveness of the colistin/levofloxacin regimen compared to the usual colistin/meropenem regimen in the treatment of patients with VAP caused by CRAB.
Experimental approach: The patients with VAP were randomly assigned to experimental (n = 26) and control (n = 29) groups. The first group received IV colistin 4.5 MIU every 12 h + levofloxacin 750 mg IV daily, and the second group received IV colistin with the same dose + meropenem 1 g IV every 8 h for 10 days. The clinical (complete response, partial response, or treatment failure) and microbiological responses at the end of the intervention were recorded and compared between the two groups.
Findings/Results: The complete response rate was higher (n = 7; 35%) and the failure rate was lower (n = 4; 20%) in the experimental group than in the control group (n = 2; 8%, and n = 11; 44%, respectively), but the differences were not statistically significant. Even though the microbiological response rate was higher in the experimental group (n = 14; 70%) than in the control group (n = 12; 48%), the difference was not statistically significant. The mortality rate was 6 (23.10%) and 4 patients (13.8%) in the experimental and control groups, respectively (P = 0.490).
Conclusion and implication: The levofloxacin/colistin combination can be considered an alternative regimen to meropenem/colistin in the treatment of VAP caused by CRAB. |
| first_indexed | 2024-04-10T23:22:41Z |
| format | Article |
| id | doaj.art-069c318dee264e9b90cc42564f9b23b9 |
| institution | Directory Open Access Journal |
| issn | 1735-5362 1735-9414 |
| language | English |
| last_indexed | 2024-04-10T23:22:41Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Research in Pharmaceutical Sciences |
| spelling | doaj.art-069c318dee264e9b90cc42564f9b23b92023-01-12T13:32:39ZengWolters Kluwer Medknow PublicationsResearch in Pharmaceutical Sciences1735-53621735-94142023-01-01181394810.4103/1735-5362.363594The effectiveness of colistin/levofloxacin compared to colistin/meropenem in the treatment of ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii: a randomized controlled clinical trialMahnaz MomenzadehRasool SoltaniFatemeh ShafieeAtousa HakamifardMorteza PourahmadSaeed AbbasiBackground and purpose: The treatment of ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii (CRAB) is still a great challenge. This study evaluated the effectiveness of the colistin/levofloxacin regimen compared to the usual colistin/meropenem regimen in the treatment of patients with VAP caused by CRAB. Experimental approach: The patients with VAP were randomly assigned to experimental (n = 26) and control (n = 29) groups. The first group received IV colistin 4.5 MIU every 12 h + levofloxacin 750 mg IV daily, and the second group received IV colistin with the same dose + meropenem 1 g IV every 8 h for 10 days. The clinical (complete response, partial response, or treatment failure) and microbiological responses at the end of the intervention were recorded and compared between the two groups. Findings/Results: The complete response rate was higher (n = 7; 35%) and the failure rate was lower (n = 4; 20%) in the experimental group than in the control group (n = 2; 8%, and n = 11; 44%, respectively), but the differences were not statistically significant. Even though the microbiological response rate was higher in the experimental group (n = 14; 70%) than in the control group (n = 12; 48%), the difference was not statistically significant. The mortality rate was 6 (23.10%) and 4 patients (13.8%) in the experimental and control groups, respectively (P = 0.490). Conclusion and implication: The levofloxacin/colistin combination can be considered an alternative regimen to meropenem/colistin in the treatment of VAP caused by CRAB.http://www.rpsjournal.net/article.asp?issn=1735-5362;year=2023;volume=18;issue=1;spage=39;epage=48;aulast=Momenzadehacinetobacter baumannii; colistin; levofloxacin; meropenem; ventilator-associated pneumonia. |
| spellingShingle | Mahnaz Momenzadeh Rasool Soltani Fatemeh Shafiee Atousa Hakamifard Morteza Pourahmad Saeed Abbasi The effectiveness of colistin/levofloxacin compared to colistin/meropenem in the treatment of ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii: a randomized controlled clinical trial Research in Pharmaceutical Sciences acinetobacter baumannii; colistin; levofloxacin; meropenem; ventilator-associated pneumonia. |
| title | The effectiveness of colistin/levofloxacin compared to colistin/meropenem in the treatment of ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii: a randomized controlled clinical trial |
| title_full | The effectiveness of colistin/levofloxacin compared to colistin/meropenem in the treatment of ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii: a randomized controlled clinical trial |
| title_fullStr | The effectiveness of colistin/levofloxacin compared to colistin/meropenem in the treatment of ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii: a randomized controlled clinical trial |
| title_full_unstemmed | The effectiveness of colistin/levofloxacin compared to colistin/meropenem in the treatment of ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii: a randomized controlled clinical trial |
| title_short | The effectiveness of colistin/levofloxacin compared to colistin/meropenem in the treatment of ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii: a randomized controlled clinical trial |
| title_sort | effectiveness of colistin levofloxacin compared to colistin meropenem in the treatment of ventilator associated pneumonia vap caused by carbapenem resistant acinetobacter baumannii a randomized controlled clinical trial |
| topic | acinetobacter baumannii; colistin; levofloxacin; meropenem; ventilator-associated pneumonia. |
| url | http://www.rpsjournal.net/article.asp?issn=1735-5362;year=2023;volume=18;issue=1;spage=39;epage=48;aulast=Momenzadeh |
| work_keys_str_mv | AT mahnazmomenzadeh theeffectivenessofcolistinlevofloxacincomparedtocolistinmeropeneminthetreatmentofventilatorassociatedpneumoniavapcausedbycarbapenemresistantacinetobacterbaumanniiarandomizedcontrolledclinicaltrial AT rasoolsoltani theeffectivenessofcolistinlevofloxacincomparedtocolistinmeropeneminthetreatmentofventilatorassociatedpneumoniavapcausedbycarbapenemresistantacinetobacterbaumanniiarandomizedcontrolledclinicaltrial AT fatemehshafiee theeffectivenessofcolistinlevofloxacincomparedtocolistinmeropeneminthetreatmentofventilatorassociatedpneumoniavapcausedbycarbapenemresistantacinetobacterbaumanniiarandomizedcontrolledclinicaltrial AT atousahakamifard theeffectivenessofcolistinlevofloxacincomparedtocolistinmeropeneminthetreatmentofventilatorassociatedpneumoniavapcausedbycarbapenemresistantacinetobacterbaumanniiarandomizedcontrolledclinicaltrial AT mortezapourahmad theeffectivenessofcolistinlevofloxacincomparedtocolistinmeropeneminthetreatmentofventilatorassociatedpneumoniavapcausedbycarbapenemresistantacinetobacterbaumanniiarandomizedcontrolledclinicaltrial AT saeedabbasi theeffectivenessofcolistinlevofloxacincomparedtocolistinmeropeneminthetreatmentofventilatorassociatedpneumoniavapcausedbycarbapenemresistantacinetobacterbaumanniiarandomizedcontrolledclinicaltrial AT mahnazmomenzadeh effectivenessofcolistinlevofloxacincomparedtocolistinmeropeneminthetreatmentofventilatorassociatedpneumoniavapcausedbycarbapenemresistantacinetobacterbaumanniiarandomizedcontrolledclinicaltrial AT rasoolsoltani effectivenessofcolistinlevofloxacincomparedtocolistinmeropeneminthetreatmentofventilatorassociatedpneumoniavapcausedbycarbapenemresistantacinetobacterbaumanniiarandomizedcontrolledclinicaltrial AT fatemehshafiee effectivenessofcolistinlevofloxacincomparedtocolistinmeropeneminthetreatmentofventilatorassociatedpneumoniavapcausedbycarbapenemresistantacinetobacterbaumanniiarandomizedcontrolledclinicaltrial AT atousahakamifard effectivenessofcolistinlevofloxacincomparedtocolistinmeropeneminthetreatmentofventilatorassociatedpneumoniavapcausedbycarbapenemresistantacinetobacterbaumanniiarandomizedcontrolledclinicaltrial AT mortezapourahmad effectivenessofcolistinlevofloxacincomparedtocolistinmeropeneminthetreatmentofventilatorassociatedpneumoniavapcausedbycarbapenemresistantacinetobacterbaumanniiarandomizedcontrolledclinicaltrial AT saeedabbasi effectivenessofcolistinlevofloxacincomparedtocolistinmeropeneminthetreatmentofventilatorassociatedpneumoniavapcausedbycarbapenemresistantacinetobacterbaumanniiarandomizedcontrolledclinicaltrial |