Abstract:
Background: The optimal ampicillin-sulbactam dosing regimen for carbapenem-susceptible Acinetobacter baumannii isolates in critically ill trauma patients has not been clearly defined. One strategy to provide the adequate sulbactam dose includes high-dose continuous infusion. Case(s) Description: We present three cases of critically ill trauma patients with augmented renal clearance treated with high-dose ampicillin-sulbactam through an intravenous continuous infusion for ventilator-associated pneumonia. All A. baumannii isolates were susceptible to sulbactam with low minimum inhibitory concentrations. All achieved clinical cure at the end of therapy and no recurrent pneumonia was noted. No clinically substantial adverse effect attributable to ampicillin-sulbactam therapy occurred. Discussion: There is limited evidence to endorse high-dose, continuous infusion ampicillin-sulbactam for treatment of infections caused by carbapenem-susceptible A. baumannii. This report presents three critically ill trauma patients with augmented renal clearance that achieved positive clinical outcomes with higher doses of ampicillin-sulbactam administered through a continuous infusion.
摘要:
背景:尚未明确定义用于危重创伤患者中碳青霉烯类敏感鲍曼不动杆菌的最佳氨苄西林-舒巴坦给药方案。提供足够舒巴坦剂量的一种策略包括高剂量连续输注。病例描述:我们介绍了三例危重创伤患者,通过静脉连续输注呼吸机相关性肺炎,用大剂量氨苄西林-舒巴坦治疗肾脏清除率增强。所有鲍曼不动杆菌分离株对最低抑制浓度低的舒巴坦敏感。在治疗结束时全部达到临床治愈,并且没有发现复发性肺炎。没有发生可归因于氨苄西林-舒巴坦治疗的临床实质性不良反应。讨论:支持高剂量的证据有限,持续输注氨苄西林-舒巴坦用于治疗碳青霉烯类敏感的鲍曼不动杆菌引起的感染。本报告介绍了三名患有肾脏清除率增强的危重创伤患者,通过连续输注给予更高剂量的氨苄西林-舒巴坦,取得了积极的临床结果。