Journal of Infection and Public Health
High-dose sulbactam for extensively drug-resistant
Von Jiaxin Yu, Zhiqiu He, Yunmeng Pang und 3 weiteren.
Inhalt auf Englisch
Abstract
Objectives
The therapeutic effect and tolerability of sulbactam, at a daily dose of at least 9 g, were assessed in critically ill individuals who acquired extensively drug-resistant Acinetobacter baumannii (XDR-AB) infection.
Methods
This single-center retrospective cohort evaluated a primary composite endpoint of death from any cause or invasive mechanical ventilation (IMV) within 28 days. Secondary endpoints comprising the 14-day composite outcome, IMV-free and ICU-free days through day 28.
Results
The study cohort comprised 114 patients diagnosed with XDR-AB infection, of whom 72 (63.2%) received high-dose SBT-containing therapy. The high-dose SBT group showed a lower incidence of the composite outcomes, a higher IMV-free rate, and more IMV-free days through 28 days, with consistent results after adjustment using inverse probability of treatment weighting (IPTW) or the overlap weighting (OW) approach. The observed association of high-dose SBT did not differ significantly by concomitant antibiotic regimen. Within-regimen analysis showed that patients receiving polymyxin B plus high-dose SBT had more IMV-free days through day 28 (mean difference 4.0 days, P = 0.025). No increased signal of nephrotoxicity, hepatotoxicity, or other SBT-related adverse events was observed during the 7-day monitoring period.