Clinical Efficacy and Outcome Analysis of 31 Cases of Corona Virus Disease 2019 Complicated with Extensively Drug-Resistant Acinetobacter Baumannii Severe Pneumonia
Objective To provide a reference for the rational use of antibacterial drugs and optimize the diagnosis and treatment strategies of extensively drug-resistant Acinetobacter baumannii(XDRAB)pulmonary infection in clinical practice.Methods The medical data,antibacterial treatment regimens,clinical efficacy and 30-day mortality of patients with corona virus disease 2019(COVID-19)and XDRAB severe pneumonia admitted to the hospital from December 2022 to February 2023 were retrospectively analyzed.Results A total of 31 patients were included and divided into the polymyxin group(fifteen cases),the non-polymyxin group(twelve cases)and the untreated group(four cases)based on different treatment regimens.The patients in the polymyxin group were mainly treated with Polymyxin B Sulfate for Injection or Colistin Sulfate for Injection and given other drugs simultaneously.The patients in the non-polymyxin group were treated with any one or more of Tigecycline for Injection,Cefoperazone Sodium and Sulbactam Sodium for Injection,Sulbactam Sodium for Injection,Meropenem for Injection,Imipenem and Cilastatin Sodium for Injection and Omadacycline Tosilate for Injection.The patients in the polymyxin group and non-polymyxin group were treated for no less than 2 d.The patients in the untreated group were treated with other drugs not including the above ones.The effective rate and 30-day mortality was 26.67%and 73.33%in the polymyxin group,16.67%and 83.33%in the non-polymyxin group,0 and 100.00%in the untreated group respectively.Clinical pharmacists participated in the treatment of six cases in the polymyxin group,two of whom obtained effective treatment(33.33%).Conclusion There is a low clinical cure rate and high mortality in the patients with COVID-19 and XDRAB severe pneumonia,who require more accurate antibacterial treatment timing and more standardized drug treatment,and the participation of clinical pharmacists in the treatment may bring more clinical benefits.
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