Epidemiology, Resistance, and Outcomes of Acinetobacter baumannii Bacteremia Treated with Imipenem-Cilastatin or Ampicillin-Sulbactam

Study Objective. To evaluate epidemiology, resistance, and treatment outcomes of Acinetobacter baumannii bacteremia treated with imipenemcilastatin or ampicillin‐sulbactam for 72 hours or longer. Design. Retrospective analysis. Setting. University teaching hospital. Patients. Forty‐eight patients with A. baumannii bacteremia. Intervention. Evaluation of susceptibility and clinical data from 48 patients treated with either ampicillin‐sulbactam or imipenem‐cilastatin from 1987–1999. Measurements and Main Results. Comparing ampicillin‐sulbactam and imipenem‐cilastatin, there were no differences between days of bacteremia (4 vs 2 days, p=0.05), days to resolution of temperature or white blood cell count, success or failure during or at end of treatment, or intensive care unit total or antibiotic‐related length of stay (13 vs 10 days, p=0.05). Patients treated with ampicillin‐sulbactam had significantly decreased antibiotic treatment costs ($1500 vs $500, p=0.004). Conclusion. Ampicillin‐sulbactam is at least as effective as imipenemcilastatin based on clinical response at days 2, 7, and end of treatment and is a cost‐effective alternative for treatment of A. baumannii infections.