Evaluation of Alone or Combined Colistin Therapy Success in Patients with Carbapenem-Resistant Acinetobacter Pneumonias

Abstract

Aim Carbapenem-resistant gram negative bacteria represent an increasing problem worldwide for intensive care units. We aimed to detect the outcome of different treatment regimens and mortality rates of Acinetobacter infection in our clinic. Is combined colistin therapy superior or not? Material and Method: 23 cases diagnosed and treated in our unit with documented Acinetobacter infections between January 2013 and June 2014 were retrospectively evaluated in terms of treatments administered and mortality rates. Results: 19 of 23 patients were treated in ICU and 4 of 23 patients were treated in normal patient ward. Among 19 ICU patients, 2 patients in cefoperazone + sulbactam - susceptible groups and 3 patients with cefaperazone + sulbactam - resistant groups died with colistin monotherapy. Among patients receiving combined treatment, two patients were given amikacin + colistin combination and they both died. A single patient receiving colistin + rifampicin combination responded well. Of the 4 patients treated in the normal patient ward, 3 had carbapenem resistance, and of these, only 1 was susceptible to colistin. This patient received colistin + tigecycline combination and had good response. Discussion: The combined colistin treatment seems plausible in terms of reducing mortality in Acinetobacter infections of lung. We believe that in patients with carbapenem-resistant Acinetobacter infections, a consideration should be given to rifampicin or tigecycline combination with colistin.