Kanchanasuwan Siripen, Kositpantawong Narongdet, Singkhamanan Kamonnut, Hortiwakul Thanaporn, Charoenmak Boonsri, Ozioma F Nwabor, Doi Yohei, Chusri Sarunyou
Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110, Thailand.
Department of Biomedical Sciences, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110, Thailand.
Infect Drug Resist. 2021 Mar 29;14:1255-1264. doi: 10.2147/IDR.S305819. eCollection 2021.
The efficacy of adjunctive therapy with cefoperazone-sulbactam (CEP-SUL) for ventilator-associated pneumonia (VAP) due to carbapenem-resistant (CRAB) is unclear.
We retrospectively analyzed the therapeutic effect of adding CEP-SUL to standard regimens for VAP due to CRAB. Patients with VAP due to CRAB strains that were susceptible to CEP-SUL were enrolled into the study. The patients were divided into two groups: those who receive cefoperazone-sulbactam (CEP-SUL), and those who did not receive cefoperazone-sulbactam (CEP-SUL). Mortality rates and resource utilization of these two groups were compared. Factors associated with mortality were explored.
Eighty patients were enrolled into the study, 52 CEP-SUL and 28 CEP-SUL. The baseline characteristics of the two groups were comparable, except for median Acute Physiology and Chronic Health Evaluation (APACHE) II score which was significantly higher for CEP-SUL. Thirty-day, and in-hospital mortality rates for CEP-SUL were significantly lower than CEP-SUL with values of 35%, 39% and 61%, 68%, for CEP-SUL and CEP-SUL, respectively. The survival rate for CEP-SUL was significantly higher compared with CEP-SUL ( < 0.001). The number of hospital days, ventilator days since diagnosis of VAP and hospital costs were lower for CEP-SUL.
Overall results suggested that patients with VAP due to CRAB strains who received adjunctive therapy with CEP-SUL had lower mortality rates and resource utilization compared with CEP-SUL.
头孢哌酮-舒巴坦（CEP-SUL）辅助治疗耐碳青霉烯类鲍曼不动杆菌（CRAB）所致呼吸机相关性肺炎（VAP）的疗效尚不清楚。
我们回顾性分析了在治疗CRAB所致VAP的标准方案中加用CEP-SUL的治疗效果。将对CEP-SUL敏感的CRAB菌株所致VAP患者纳入研究。患者分为两组：接受头孢哌酮-舒巴坦（CEP-SUL）的患者和未接受头孢哌酮-舒巴坦（CEP-SUL）的患者。比较两组的死亡率和资源利用情况。探讨与死亡率相关的因素。
80例患者纳入研究，52例接受CEP-SUL，28例未接受CEP-SUL。两组的基线特征具有可比性，但接受CEP-SUL组的急性生理与慢性健康状况评分（APACHE）II中位数显著更高。接受CEP-SUL组的30天和住院死亡率显著低于未接受CEP-SUL组，分别为35%、39%和61%、68%。接受CEP-SUL组的生存率显著高于未接受CEP-SUL组（P<0.001）。接受CEP-SUL组的住院天数、自诊断VAP起的呼吸机使用天数和住院费用更低。
总体结果表明，与未接受CEP-SUL的患者相比，接受CEP-SUL辅助治疗的CRAB菌株所致VAP患者的死亡率和资源利用更低。
