Epidemiology and Infection

Original Papers

MRSA and HAI

Colistin vs. the combination of colistin and rifampicin for the treatment of carbapenem-resistant Acinetobacter baumannii ventilator-associated pneumonia

H. AYDEMIRa1 c1, D. AKDUMANa1, N. PISKINa1, F. COMERTa2, E. HORUZa1, A. TERZIa2, F. KOKTURKa3, T. ORNEKa4 and G. CELEBIa1

a1 Bulent Ecevit University Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Zonguldak, Turkey

a2 Bulent Ecevit University, Medical Faculty, Department of Microbiology, Zonguldak, Turkey

a3 Bulent Ecevit University, Medical Faculty, Department of Biostatistics, Zonguldak, Turkey

a4 Bulent Ecevit University, Medical Faculty, Department of Pulmonary Disease, Zonguldak, Turkey

SUMMARY

The aim of this study was to compare the responses of colistin treatment alone vs. a combination of colistin and rifampicin in the treatment of ventilator-associated pneumonia (VAP) caused by a carbapenem-resistant A. baumannii strain. Forty-three patients were randomly assigned to one of two treatment groups. Although clinical (P = 0·654), laboratory (P = 0·645), radiological (P = 0·290) and microbiological (P = 0·597) response rates were better in the combination group, these differences were not significant. However, time to microbiological clearance (3·1 ± 0·5 days, P = 0·029) was significantly shorter in the combination group. The VAP-related mortality rates were 63·6% (14/22) and 38·1% (8/21) for the colistin and the combination groups (P = 0·171), respectively. Our results suggest that the combination of colistin with rifampicin may improve clinical and microbiological outcomes of VAP patients infected with A. baumannii.

(Received May 02 2012)

(Revised August 07 2012)

(Accepted August 08 2012)

(Online publication September 07 2012)

Key words

  • Acinetobacter baumannii ;
  • adverse drug reaction;
  • colistin;
  • ventilator-associated pneumonia

Correspondence

c1 Author for correspondence: H. Aydemir, M.D., Bulent Ecevit University Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, 67600 Zonguldak, Turkey. (Email: drhaydemir@yahoo.com)

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