Management of Pneumonia and Blood Stream Infections with New Antibiotic Adjuvant Entity (Ceftriaxone + Sulbactam + Disodium Edetate)- A Novel Way to Spare Carbapenems
Introduction: Nosocomial infections have been considered as a major health problem causing incremental morbidity, mortality and costs of therapy. Aim: This retrospective study was initiated with aim to analyse the comparative efficacy of a novel Antibiotic Adjuvant Entity (AAE), a combination o...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-12-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/9014/20904_CE[Ra1]_(DK)_RB_PF1_PFA(AK)_PF2(PAG).pdf |
| Summary: | Introduction: Nosocomial infections have been considered as
a major health problem causing incremental morbidity, mortality
and costs of therapy.
Aim: This retrospective study was initiated with aim to analyse
the comparative efficacy of a novel Antibiotic Adjuvant Entity
(AAE), a combination of ceftriaxone + sulbactam + disodium
edetate and meropenem in combination with colistin, for the
management of Multi Drug Resistant (MDR) nosocomial Gramnegative bacterial infections.
Materials and Methods: Case history sheets of patients with
documented MDR nosocomial Gram-negative infections who
received either AAE or meropenem in combination with colistin for
management of infections over a period of 3 years (November 2012
– October 2015) were included in the study. Data related to clinical
management, demographics, vital signs and laboratory parameters
along with prior antibiotic therapy, dose and clinical outcomes were
evaluated thoroughly to analyse the clinical benefits of this new AAE+
colistin therapy for management of MDR nosocomial infections.
Results: Out of 115 patients short listed for the study, 52
patients had received AAE + colistin therapy and 63 patients
have received meropenem + colistin. AAE + colistin therapy
resulted in significantly higher efficacy (86.53%) as compared
to meropenem + colistin (63.49%). A rising trend in clinical
cure rates was observed in AAE based combination therapy
in contrast to the decreasing trend in meropenem based
combination therapy. A progressive decline in clinical cure rates
was observed in meropenem treated group over a period of 3
years due to rising carbapenemases and multiple resistance by
pathogens, where as AAE maintained the same efficacy.
Conclusion: The AAE + colistin therapy has shown better
bacteriological and clinical efficacy as compared to meropenem
+ colistin in the management of various nosocomial MDR Gramnegative infections. A significant number of meropenem failure
patients responded to the AAE therapy highlighting the new
hope to spare carbapenems. |
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| ISSN: | 2249-782X 0973-709X |