Management of CNS and VAP Infections with a New Ready to use Combination: A Retrospective Study
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 4
Abstract
Introduction: The present retrospective study was aimed to analyze the efficacy of ready to use combination (RTUC) of (ceftriaxone + vancomycin) along with metronidazole compared to other drug combinations for management of ICU patients suffering from post-operative central nervous system (POCNS) and ventilator associated pneumonia (VAP) infections due to multi-drug resistant (MDR) gram-positive bacteria. Material and Methods: This study analyzed the data of 208 patients treated at a tertiary-care hospital. Patient demographic characteristics, infection type, co-morbidities, antibiotic therapy, dosage, treatment duration have been studied. Microbiological success was measured in terms of bacterial eradication, while clinical success was monitored in terms of complete omission of systemic signs and symptoms. Results: Among 208 patients analyzed, 150 cases were found to be suffering from POCNS infections and 58 patients were of VAP. Out of these 208 patients, 79 cases were treated with empirical use of Meropenem-Vancomycin (MER-VAN), 55 cases were treated with empirical use of Piperacillin Tazobactam-Tigecycline (PTZTIG) and the remaining 74 cases were treated with empirical use of Ready to Use Combination of Vancomycin and Ceftriaxone along with Metronidazole (RTUC-Metro). The clinical cure rates reported in MER-VAN, PTZ-TIG and RTUC-Metro groups were 77.2%, 72.7%, and 81.1% respectively. Conclusion: Infections with MDR gram-positive bacteria are frequent in ICU patients and the current study demonstrates that RTUC in combination with metronidazole has comparatively equivalent efficacy to MER-VAN and better than PTZ-TIG combinations. The results of this retrospective study favors the use of RTUC as a safer alternative to any other available drugs to treat ICU patients with infections caused due to MDR gram-positive bacteria. However more data from other centers on different indications needs to collected in favor of this new combination.
Authors and Affiliations
Obaid Ahmad Siddiqui, Lubna Zafar, Mohammad Amin Mir
Keywords
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