Clinical Outcomes and Safety of Meropenem–Colistin versus Meropenem–Tigecycline in Patients with Carbapenem-Resistant <i>Acinetobacter baumannii</i> Pneumonia
This study compared the clinical outcomes and safety of meropenem–colistin versus meropenem–tigecycline in the treatment of adult patients with carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB) pneumonia. A retrospective observational study of patients with CRAB pneumonia was pe...
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MDPI AG
2021-07-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/10/8/903 |
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| author | Jae-Min Park Kyung-Sook Yang You-Seung Chung Ki-Byung Lee Jeong-Yeon Kim Sun-Bean Kim Jang-Wook Sohn Young-Kyung Yoon |
| author_facet | Jae-Min Park Kyung-Sook Yang You-Seung Chung Ki-Byung Lee Jeong-Yeon Kim Sun-Bean Kim Jang-Wook Sohn Young-Kyung Yoon |
| author_sort | Jae-Min Park |
| collection | DOAJ |
| description | This study compared the clinical outcomes and safety of meropenem–colistin versus meropenem–tigecycline in the treatment of adult patients with carbapenem-resistant <i>Acinetobacter baumannii</i> (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; <i>p</i> = 0.007) and meropenem–colistin combination therapy (aHR, 2.58; 95% CI, 1.07–6.23; <i>p</i> = 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%, <i>p</i> = 0.001). Meropenem–tigecycline combination therapy might be a valuable treatment option for patients with CRAB pneumonia. |
| first_indexed | 2024-03-10T09:04:31Z |
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| id | doaj.art-a6bd3a44639d453b8ab269136b1bf0fe |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T09:04:31Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-a6bd3a44639d453b8ab269136b1bf0fe2023-11-22T06:33:01ZengMDPI AGAntibiotics2079-63822021-07-0110890310.3390/antibiotics10080903Clinical Outcomes and Safety of Meropenem–Colistin versus Meropenem–Tigecycline in Patients with Carbapenem-Resistant <i>Acinetobacter baumannii</i> PneumoniaJae-Min Park0Kyung-Sook Yang1You-Seung Chung2Ki-Byung Lee3Jeong-Yeon Kim4Sun-Bean Kim5Jang-Wook Sohn6Young-Kyung Yoon7Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, 145 Anam-ro, Seongbuk-gu, Seoul 02841, KoreaDepartment of Biostatistics, Korea University College of Medicine, 145 Anam-ro, Seongbuk-gu, Seoul 02841, KoreaDivision of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, 145 Anam-ro, Seongbuk-gu, Seoul 02841, KoreaDivision of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, 145 Anam-ro, Seongbuk-gu, Seoul 02841, KoreaDivision of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, 145 Anam-ro, Seongbuk-gu, Seoul 02841, KoreaDivision of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, 145 Anam-ro, Seongbuk-gu, Seoul 02841, KoreaDivision of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, 145 Anam-ro, Seongbuk-gu, Seoul 02841, KoreaDivision of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, 145 Anam-ro, Seongbuk-gu, Seoul 02841, KoreaThis study compared the clinical outcomes and safety of meropenem–colistin versus meropenem–tigecycline in the treatment of adult patients with carbapenem-resistant <i>Acinetobacter baumannii</i> (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; <i>p</i> = 0.007) and meropenem–colistin combination therapy (aHR, 2.58; 95% CI, 1.07–6.23; <i>p</i> = 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%, <i>p</i> = 0.001). Meropenem–tigecycline combination therapy might be a valuable treatment option for patients with CRAB pneumonia.https://www.mdpi.com/2079-6382/10/8/903<i>Acinetobacter baumannii</i>meropenemtigecyclinecolistin |
| spellingShingle | Jae-Min Park Kyung-Sook Yang You-Seung Chung Ki-Byung Lee Jeong-Yeon Kim Sun-Bean Kim Jang-Wook Sohn Young-Kyung Yoon Clinical Outcomes and Safety of Meropenem–Colistin versus Meropenem–Tigecycline in Patients with Carbapenem-Resistant <i>Acinetobacter baumannii</i> Pneumonia Antibiotics <i>Acinetobacter baumannii</i> meropenem tigecycline colistin |
| title | Clinical Outcomes and Safety of Meropenem–Colistin versus Meropenem–Tigecycline in Patients with Carbapenem-Resistant <i>Acinetobacter baumannii</i> Pneumonia |
| title_full | Clinical Outcomes and Safety of Meropenem–Colistin versus Meropenem–Tigecycline in Patients with Carbapenem-Resistant <i>Acinetobacter baumannii</i> Pneumonia |
| title_fullStr | Clinical Outcomes and Safety of Meropenem–Colistin versus Meropenem–Tigecycline in Patients with Carbapenem-Resistant <i>Acinetobacter baumannii</i> Pneumonia |
| title_full_unstemmed | Clinical Outcomes and Safety of Meropenem–Colistin versus Meropenem–Tigecycline in Patients with Carbapenem-Resistant <i>Acinetobacter baumannii</i> Pneumonia |
| title_short | Clinical Outcomes and Safety of Meropenem–Colistin versus Meropenem–Tigecycline in Patients with Carbapenem-Resistant <i>Acinetobacter baumannii</i> Pneumonia |
| title_sort | clinical outcomes and safety of meropenem colistin versus meropenem tigecycline in patients with carbapenem resistant i acinetobacter baumannii i pneumonia |
| topic | <i>Acinetobacter baumannii</i> meropenem tigecycline colistin |
| url | https://www.mdpi.com/2079-6382/10/8/903 |
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