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Comparison of Two Therapeutic Approaches for the Management of Ventilator-Associated Pneumonia Due to Multidrug-Resistant Acinetobacter: A Randomized Clinical Trial Study Publisher Pubmed



Khorvash F1 ; Yaghoubi S2 ; Farsaei S3 ; Ataei B4 ; Hakamifard A2 ; Mohajeri F2 ; Gudarzi M2
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Authors Affiliations
  1. 1. Acquired Immunodeficiency Research Center, Isfahan University of medical sciences, Isfahan, Iran
  2. 2. Department of infectious disease, School of medicine, Isfahan University of medical sciences, Isfahan, Iran
  3. 3. Department of clinical pharmacy and pharmacy practice, Isfahan University of medical sciences, Isfahan, Iran
  4. 4. Infectious disease and tropical medicine research center, Isfahan University of medical sciences, Isfahan, Iran

Source: Journal of Immunoassay and Immunochemistry Published:2020


Abstract

Management of ventilator-associated pneumonia (VAP) is a puzzling issue for infectious disease specialist. The present clinical trial study was aimed to comparing the effects of injectable colistin plus nebulized colistin and injectable colistin plus nebulized tobramycin on management of patients with VAP due to multidrug-resistant Acinetobacter. VAP patients were randomly divided into two groups (n = 30/each): Group 1–patients that received intravenous (IV) meropenem, injectable colistin plus nebulized colistin, as a routine treatment, and Group 2–patients that received IV meropenem, injectable colistin plus nebulized tobramycin. A total of 14 days of therapeutic intervention are required for every case. Follow-up for subjects was performed at five time-points: days 1, 3, 5, 7, and 14 after intervention. Also, a mean of creatinine levels of patients was determined in five times. In the present study, the clinical pulmonary infection score (CPIS) was determined on the basis of points assigned for various clinically manifestations of VAP. Based on our statistical analysis, there was no significant difference between CPIS and creatinine level in both Groups 1 and 2 (p > .05). CPIS and other clinical investigation appeared effectiveness of the treatment with injected colistin plus nebulized tobramycin; on the other hand, the results of present clinical trial showed that aforementioned therapeutic approach can be used as an alternative treatment for the management of infection in VAP patients. © 2019, © 2019 Taylor & Francis.
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