Outcomes of adjunctive therapy with intravenous cefoperazone-sulbactam for ventilator-associated pneumonia due to carbapenem-resistant Acinetobacter baumannii

Introduction: The efficacy of adjunctive therapy with cefoperazone-sulbactam (CEP-SUL) for ventilator-associated pneumonia (VAP) due to carbapenem-resistant A. baumannii (CRAB) is unclear. Methods: We retrospectively analyzed the therapeutic effect of adding CEP-SUL to standard regimens for VAP due to CRAB. Patients with VAP due to CRAB strains that were susceptible to CEP-SUL were enrolled into the study. The patients were divided into two groups: Those who receive cefoperazone-sulbactam (CEP-SUL⁺), and those who did not receive cefoperazone-sulbactam (CEP-SUL). Mortality rates and resource utilization of these two groups were compared. Factors associated with mortality were explored. Results: Eighty patients were enrolled into the study, 52 CEP-SUL⁺ and 28 CEP-SUL^–. The baseline characteristics of the two groups were comparable, except for median Acute Physiology and Chronic Health Evaluation (APACHE) II score which was significantly higher for CEP-SUL⁺. Thirty-day, and in-hospital mortality rates for CEP-SUL⁺ were significantly lower than CEP-SUL^– with values of 35%, 39% and 61%, 68%, for CEPSUL⁺ and CEP-SUL^–, respectively. The survival rate for CEP-SUL⁺ was significantly higher compared with CEP-SUL^– (P < 0.001). The number of hospital days, ventilator days since diagnosis of VAP and hospital costs were lower for CEP-SUL⁺. Conclusion: Overall results suggested that patients with VAP due to CRAB strains who received adjunctive therapy with CEP-SUL had lower mortality rates and resource utilization compared with CEP-SUL^–.