Clinical efficacy and adverse reactions of tigecycline in treatment of healthcareassociated pneumonia caused by extensively drugresistant Acinetobacter baumannii

Abstract:

ObjectiveTo observe the clinical efficacy and adverse reactions of tigecycline in treatment of healthcareassociated pneumonia (HAP) caused by extensively drugresistant Acinetobacter baumannii (XDRAB).MethodsClinical data of patients who used tigecycline for the treatment of XDRAB HAP in intensive care units of a hospital from March 2013 to June 2014 were retrospectively analyzed.ResultsXDRAB isolated from 31 patients with HAP were all sensitive to tigecycline, the resistance rates to carbapenems and sulbactams (including cefoperazonesulbactam, SCF) were all 100%，17 cases （54.84%）were mixed infection. Combined use rates of tigecycline and SCF were 85.71%（12/14）in respiratory intensive care unit(RICU) and 47.06%（8/17） in general intensive care unit(GICU). Of 31 patients, the cure rate, effective rate, bacterial clearance rate, and antimicrobial adverse reaction rate were 29.03%，45.16%, 61.29%, and 16.13% respectively, no serious adverse drug reactions occurred. In RICU group and GICU group, the cure rates were 42.86% and 17.65% respectively, effective rates were 71.43% and 23.53% respectively, and bacterial clearance rates were 78.57 % and 47.06% respectively, difference in effective rate between two groups was significant (P<0.05).Among patients receiving combination of tigecycline and SCF as well as not receiving combined SCF, the cure rates were 35.00% and 18.18% respectively, effective rates were 60.00% and 18.18% respectively, and bacterial clearance rates were 65.00% and 54.55% respectively, difference in effective rate between two groups was significant (P<0.05).ConclusionTigecycline has a good clinical efficacy and little adverse reaction in treating XDRAB HAP; tigecycline combined with SCF is a good choice.