The First Experience of Combined Use of Cefepime/Sulbactam and Aztreonam in ICU Patients with Nosocomial Infections Caused by Carbapenem-Resistant Gram-Negative Microorganisms Producing Class B and D Carbapenemases

Background . The difficulties of antibacterial therapy infections caused by carbapenemase-producing gram-negative bacteria are associated with limited options for adequate since, in addition to resistance carbapenems and other beta-lactams, these microorganisms often characterized classes antibiotics, including polymyxins. In vitro data support the idea combined use inhibitor-protected cephalosporins aztreonam treatment such infections. aim study was investigate effectiveness cefepime/sulbactam (FEP/SB) combination (ATM) class B D carbapenemase producers. Methods A prospective observational evaluated FEP/SB + ATM ICU patients nosocomial complicated sepsis or septic shock carbapenem-resistant pathogens documented production carbapenemase. ineffectiveness previous absence were used as inclusion criteria. Microbiological, clinical efficacy, 30-day mortality indicators evaluation. Results included 25 infection (76% them VAP), (60%) (40%) an average SOFA score 6 points Klebsiella pneumoniae (23 patients) Pseudomonas aeruginosa (2) producing carbapenemases OXA-48 (56%), NDM (20%), (16%), two strains P. daily dose 6.6 g, duration 9.9 days. As a result treatment, eradication achieved 68% patients, efficacy 72%, rate 28%. Conclusion Our results show good bacteriological extremely resistant K. , non-susceptible