在治疗对碳青霉烯类耐药的鲍曼不动杆菌肺炎时，可乐定与舒巴坦联合用药的效果：在治疗耐碳青霉烯类药物的鲍曼不动杆菌肺炎时，每天 9 克与 12 克对死亡率的影响：随机对照试验。

IF 4.8 2区医学 Q1 INFECTIOUS DISEASES

International Journal of Infectious Diseases Pub Date : 2024-10-16 DOI:10.1016/j.ijid.2024.107267

Chutchawan Ungthammakhun , Vasin Vasikasin , Waristha Simsiriporn , Piraporn Juntanawiwat , Dhitiwat Changpradub

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引用次数: 0

摘要

背景：目前的治疗建议是在使用大剂量舒巴坦的同时至少再使用一种药物。然而，有关舒巴坦最佳剂量的数据仍然缺乏。我们研究了与每天 9 克的剂量相比，每天 12 克的舒巴坦剂量是否能降低 CRAB 肺炎患者的死亡率：该研究是一项开放标签、优越性随机对照试验，于2019年9月至2023年9月期间在Phramongkutklao医院进行，对象为确诊为CRAB的患者。参与者被随机分配到每天服用 9 克或 12 克舒巴坦的联合用药方案。主要终点是随机分配后28天的全因死亡率：在 138 名参与者中，每天服用 12 克组别死亡率呈下降趋势（59.4% 对 47.8%；P = 0.158）。在调整了与死亡率相关的因素后，观察到每天 12 克组的死亡率更低（调整后 HR 0.54 [95% CI 0.33-0.87]; p = 0.0110）。第 7 天的微生物治愈率在 12 克/天组更高（73.2% 对 89.4%；p = 0.02）：结论：与每天 9 克的剂量相比，每天 12 克的剂量与舒巴坦联合使用可利司汀可提高死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Effect of colistin combined with sulbactam: 9 g versus 12 g per day on mortality in the treatment of carbapenems resistant Acinetobacter baumannii pneumonia: A randomized controlled trial

Background

The current treatment recommendation involves administering a high dose of sulbactam alongside at least one additional agent. However, there remains a lack of data regarding the optimal dosage of sulbactam. We investigated whether administering sulbactam at a dosage of 12 g/day decreases the mortality rate among patients with CRAB pneumonia compared to 9 g/day.

Methods

The study was an open-label, superiority, randomized controlled trial conducted at Phramongkutklao Hospital between September 2019 and September 2023 in patients diagnosed with CRAB. Participants were randomly assigned to receive a combination of colistin with either 9 or 12 g/day of sulbactam. The primary endpoint was the all-cause mortality rate at 28 days postrandomization.

Results

Among the 138 participants, there was a trend towards a lower mortality rate in the 12 g/day group (59.4% vs. 47.8%; P = 0.158). After adjusting for factors associated with mortality, a lower mortality was observed in the 12 g/day group (adjusted HR 0.54 [95% CI 0.33-0.87]; P = 0.0110). The microbiological cure rate at day 7 was higher in the 12 g/day group (73.2% vs. 89.4%; P = 0.02).

Conclusions

Colistin in combination with sulbactam at a dosage of 12 g/day may improve mortality compared to 9 g/day.

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来源期刊

International Journal of Infectious Diseases 医学-传染病学

CiteScore

18.90

自引率

2.40%

发文量

1020

审稿时长

30 days

期刊介绍： International Journal of Infectious Diseases (IJID) Publisher: International Society for Infectious Diseases Publication Frequency: Monthly Type: Peer-reviewed, Open Access Scope: Publishes original clinical and laboratory-based research. Reports clinical trials, reviews, and some case reports. Focuses on epidemiology, clinical diagnosis, treatment, and control of infectious diseases. Emphasizes diseases common in under-resourced countries.