Antimicrobial Use in Hospital-Acquired Pneumonia with

Abstract

Objective:  To study the use of antimicrobial regimens and associating clinical response  and safety in hospital-acquired pneumonia (HAP) with multidrug-resistant (MDR)  Acinetobactor baumannii  and to describe bacterial susceptibility in MDR A. baumannii HAP cases. Method: This retrospective study collected data from medical records of patients hospitalized at King Chulalongkorn Memorial hospital from January 2008 to December 2009. Results: Of 70 patients with HAP caused by MDR A. baumannii, 34 patients were male (48.58%), with a mean age of 65.89 years. 41.43% were clinically improved after antimicrobial treatment, with a mean length of hospital stay of 38.64 days. The most used antimicrobial regimen was a combination of sulbactam-containing drugs and carbapenems (30%), followed by sole or combined sulbactam-containing drugs (22.86%). All MDR A. baumannii isolates were susceptible to colistin (100%). Adverse drug reactions were found in 13 patients (19.12%) of which 1 patient experienced rash and 12 patients developed doubling serum creatinine. Conclusion:Combined sulbactam-containing drug and carbapenem was the most prescribed antimicrobial regimen to treat HAP caused by MDR  A. baumannii which is a moderate clinical response and safe regimen.Keywords: hospital-acquired pneumonia, multidrug-resistant  Acinetobactor baumannii