Adjunctive therapy of intravenous colistin to intravenous tigecycline for adult patients with non-bacteremic post-surgical intra-abdominal infection due to carbapenem-resistant Acinetobacter baumannii

Sarunyou Chusri, Kamonnut Singkhamanan, Worrawit Wanitsuwan, Yuthasak Suphasynth, Narongdet Kositpantawong, Siripen Panthuwong, Yohei Doi

Research output: Contribution to journalArticle

Abstract

Post-surgical intra-abdominal infections (IAIs) due to carbapenem-resistant Acinetobacter baumannii (CRAB) are difficult to treat due to suboptimal peritoneal penetrations of several antimicrobial agents. Tigecycline has favorable outcomes of treating IAIs due to multidrug-resistant organisms but occurrence of breakthrough bacteremia has been observed because this agent has low serum level. Colistin has in vitro activity against CRAB but data on treatment of IAIs is limited due to poor peritoneal penetration. The purpose of this retrospective study is to explore the outcomes of adjunctive intravenous (IV) colistin to IV tigecycline in the treatment of IAIs caused by CRAB. Of 28 patients with non-bacteremic post-surgical IAIs due to CRAB, 14 patients received IV tigecycline alone and 14 patients received IV tigecycline with IV colistin. The 14-day, 30-day, in-hospital mortality rates, the rate of breakthrough bacteremia and the rate of bacterial eradication were not significantly different. The adjunctive therapy of IV colistin was associated with significantly higher rates of renal complications (10/14) than those receiving IV tigecycline alone (3/14) (P value = 0.023). In addition, the patients receiving adjunctive IV colistin had significantly more unfavorable non-clinical outcomes including longer length of hospital stay (P value = 0.049) and higher antimicrobial cost (P value = 0.008) and non-antimicrobial costs (P value = 0.037). In this study, adjunctive IV colistin to conventional IV tigecycline in the treatment of non-bacteremic post-surgical IAIs caused by CRAB did not yield clinical benefit but caused higher renal complication and unfavorable non-clinical outcomes.

Original languageEnglish
Pages (from-to)681-686
Number of pages6
JournalJournal of Infection and Chemotherapy
Volume25
Issue number9
DOIs
Publication statusPublished - 01-09-2019

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Intraabdominal Infections
Colistin
Acinetobacter baumannii
Carbapenems
Bacteremia
Length of Stay
Therapeutics
Kidney
Costs and Cost Analysis
Hospital Mortality
Anti-Infective Agents
tigecycline
Retrospective Studies
Mortality
Serum

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Chusri, Sarunyou ; Singkhamanan, Kamonnut ; Wanitsuwan, Worrawit ; Suphasynth, Yuthasak ; Kositpantawong, Narongdet ; Panthuwong, Siripen ; Doi, Yohei. / Adjunctive therapy of intravenous colistin to intravenous tigecycline for adult patients with non-bacteremic post-surgical intra-abdominal infection due to carbapenem-resistant Acinetobacter baumannii. In: Journal of Infection and Chemotherapy. 2019 ; Vol. 25, No. 9. pp. 681-686.
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Adjunctive therapy of intravenous colistin to intravenous tigecycline for adult patients with non-bacteremic post-surgical intra-abdominal infection due to carbapenem-resistant Acinetobacter baumannii. / Chusri, Sarunyou; Singkhamanan, Kamonnut; Wanitsuwan, Worrawit; Suphasynth, Yuthasak; Kositpantawong, Narongdet; Panthuwong, Siripen; Doi, Yohei.

In: Journal of Infection and Chemotherapy, Vol. 25, No. 9, 01.09.2019, p. 681-686.

Research output: Contribution to journalArticle

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T1 - Adjunctive therapy of intravenous colistin to intravenous tigecycline for adult patients with non-bacteremic post-surgical intra-abdominal infection due to carbapenem-resistant Acinetobacter baumannii

AU - Chusri, Sarunyou

AU - Singkhamanan, Kamonnut

AU - Wanitsuwan, Worrawit

AU - Suphasynth, Yuthasak

AU - Kositpantawong, Narongdet

AU - Panthuwong, Siripen

AU - Doi, Yohei

PY - 2019/9/1

Y1 - 2019/9/1

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