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