ArticleThe Journal of antimicrobial chemotherapy2023
Early initiation of three-drug combinations for the treatment of carbapenem-resistant A. baumannii among COVID-19 patients.
Article in The Journal of antimicrobial chemotherapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed, 20 citations in OpenAlex.
- Clinical Outcomes of Pandrug-Resistant Versus Carbapenem-Resistant, Colistin-SusceptibleAntibiotics (Basel, Switzerland) · 2026Article
- Comparative analysis of treatment outcomes and risk factors associated with different combination antimicrobial regimens in patients with multidrug-resistant Acinetobacter baumannii pneumonia.Frontiers in cellular and infection microbiology · 2026Article
- The Impact of COVID-19 on the Epidemiology of Carbapenem Resistance.Antibiotics (Basel, Switzerland) · 2025Review
- Syndemics of Antimicrobial Resistance: Non-communicable Diseases, Social Deprivation, and the Rise of Multidrug-Resistant Infections.Infectious diseases and therapy · 2025Article
- ComparativeJAC-antimicrobial resistance · 2025Article
- Checkerboard synergistic data analysis using a Hill function-based approach.bioRxiv : the preprint server for biology · 2025Article
- The Evolution of Antimicrobial Resistance inAntibiotics (Basel, Switzerland) · 2025Review
- Frequency of cefiderocol heteroresistance among patients treated with cefiderocol for carbapenem-resistantJAC-antimicrobial resistance · 2024Article
- Optimizing Treatment for Carbapenem-ResistantInfection & chemotherapy · 2024Review
- Therapeutic drug monitoring of six contraindicated/co-administered drugs by simple and green RP-HPLC-PDA; application to spiked human plasma.BMC chemistry · 2024Article
- Co-Administration of High-Dose Nebulized Colistin forAntibiotics (Basel, Switzerland) · 2024Article
- Determining Susceptibility and Potential Mediators of Resistance for the Novel Polymyxin Derivative, SPR206, inAntibiotics (Basel, Switzerland) · 2024Article
- Sustaining Functionality of Not-for-Profit Health Organisations During Pandemics: Lessons and COVID 19 Experience from Makerere University Walter Reed Project.The East African health research journal · 2024Article
- Carbapenem-resistantJournal of research in pharmacy practiceReview
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesWe evaluated the clinical characteristics and outcomes of patients with COVID-19 who received three-drug combination regimens for treatment of carbapenem-resistant Acinetobacter baumannii (CRAB) infections during a single-centre outbreak. Our objective was to describe the clinical outcomes and molecular characteristics and in vitro synergy of antibiotics against CRAB isolates. MATERIALS AND
methodsPatients with severe COVID-19 admitted between April and July 2020 with CRAB infections were retrospectively evaluated. Clinical success was defined as resolution of signs/symptoms of infection without need for additional antibiotics. Representative isolates underwent whole-genome sequencing (WGS) and in vitro synergy of two- or three-drug combinations was assessed by checkerboard and time-kill assays, respectively.
resultsEighteen patients with CRAB pneumonia or bacteraemia were included. Treatment regimens included high-dose ampicillin-sulbactam, meropenem, plus polymyxin B (SUL/MEM/PMB; 72%), SUL/PMB plus minocycline (MIN; 17%) or other combinations (12%). Clinical resolution was achieved in 50% of patients and 30-day mortality was 22% (4/18). Seven patients had recurrent infections, during which further antimicrobial resistance to SUL or PMB was not evident. PMB/SUL was the most active two-drug combination by checkerboard. Paired isolates collected before and after treatment with SUL/MEM/PMB did not demonstrate new gene mutations or differences in the activity of two- or three-drug combinations.
conclusionsUse of three-drug regimens for severe CRAB infections among COVID-19 resulted in high rates of clinical response and low mortality relative to previous studies. The emergence of further antibiotic resistance was not detected phenotypically or through WGS analysis. Additional studies are needed to elucidate preferred antibiotic combinations linked to the molecular characteristics of infecting strains.
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