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Nontraditional Dosing of Ampicillin‐Sulbactam for Multidrug‐Resistant Acinetobacter baumannii Meningitis
Author(s) -
Cawley Michael J.,
Suh Caroline,
Lee Susanne,
Ackerman Bruce H.
Publication year - 2002
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.22.7.527.33676
Subject(s) - medicine , sulbactam , acinetobacter baumannii , ampicillin , population , adverse effect , vomiting , imipenem , meningitis , anesthesia , surgery , antibiotics , antibiotic resistance , microbiology and biotechnology , biology , genetics , environmental health , bacteria , pseudomonas aeruginosa
A 52‐year‐old man was admitted to a local hospital with headache, nausea, vomiting, dizziness, photophobia, and confusion after a sudden fall. Progressive changes in neurologic function were noted despite neurosurgical intervention and broad‐spectrum antimicrobial coverage. Cerebral spinal fluid (CSF) culture identified Acinetobacter baumannii that was resistant to traditionally recommended therapies of amikacin and imipenem‐cilastatin. The organism demonstrated minimum inhibitory concentrations of greater than 32 μg/ml and 8 μg/ml, respectively, for these two agents. Ampicillin 2 g‐sulbactam 1 g every 3 hours was administered based on history of therapeutic failure of traditional dosing in our thermal injury population. Repeat CSF cultures after 12 days of ampicillin‐sulbactam therapy were negative. After 35 days, the patient's A. baumannii infection was completely resolved. The patient experienced no adverse drug events or toxicity with this high‐dosage regimen.