J Anesth Perioper Med. 2018;5(4):176-185. https://doi.org/10.24015/ebcmed.japm.2018.0072
From the 1Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China; 2Department of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, CA, USA.
Correspondence to Dr. Jinlan Chen at 1301391034@qq.com, and Dr. Hong Liu at hualiu@ucdavis.edu.
EBCMED ID: ebcmed.japm.2018.0072 DOI: 10.24015/ebcmed.japm.2018.0072
Background
With essentially no drug available to control the infection caused by the extensively drug-resistant Acinetobacter baumannii (XDR-Ab) in infants and young children, this study explored the clinical outcomes of pediatric patients with drug-resistant XDR-Ab who were treated with rifampicin in combination with sulbactam sodium.
Methods
The data for clinical outcomes, microbiological responses, and side effects were collected and evaluated for 12 critically ill infants and young children diagnosed with ventilator-associated pneumonia caused by XDR-Ab following surgical treatment for congenital heart disease in a pediatric cardiac intensive care unit. This study was approved by local institutional review board (IRB).
Results
Two patients died from the complex underlining diseases. The other 10 patients were weaned off the mechanical ventilation successfully within 4-15 days after the start of treatment with rifampicin combined with sulbactam sodium and discharged home. Three cases experienced adverse side effects, including severe rash and elevated aminotransferase level.
Conclusion
The combination of rifampicin and sulbactam sodium appeared to be an effective and safe therapy for severe ventilator-associated pneumonia caused by XDR-Ab in infants and young children. Side effects such as skin rashes and elevated aminotransferase levels can be reversed once rifampicin is discontinued in time. (Funded by the Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China; the Departments of Anesthesiology and Pain Medicine of University of California Davis Health; and the National Institutes of Health.)
Article Type
Original Article
Declaration of Interests
The authors have no other potential conflicts of interest for this work.
Acknowledgements
This study was supported by the Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China; the Departments of Anesthesiology and Pain Medicine of University of California Davis Health; and the National Institutes of Health (NIH) grant (UL1 TR001860) of the University of California Davis Health.
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