Ampicillin/sulbactam: Its potential use in treating infections in critically ill patients

Adnan, Syamhanin, Paterson, David L., Lipman, Jeffrey and Roberts, Jason A. (2013) Ampicillin/sulbactam: Its potential use in treating infections in critically ill patients. International Journal of Antimicrobial Agents, 42 5: 384-389. doi:10.1016/j.ijantimicag.2013.07.012


Author Adnan, Syamhanin
Paterson, David L.
Lipman, Jeffrey
Roberts, Jason A.
Title Ampicillin/sulbactam: Its potential use in treating infections in critically ill patients
Journal name International Journal of Antimicrobial Agents   Check publisher's open access policy
ISSN 0924-8579
1872-7913
Publication date 2013-11-01
Year available 2013
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.ijantimicag.2013.07.012
Volume 42
Issue 5
Start page 384
End page 389
Total pages 6
Place of publication Amsterdam, TheNetherlands
Publisher Elsevier BV
Collection year 2014
Language eng
Formatted abstract
The purpose of this paper was to review the potential utility of ampicillin/sulbactam (SAM) as a therapy for serious infections in critically ill patients. Data for this review were identified by searches of PubMed and of the reference lists of the included articles. We found that SAM appears to have a number of characteristics that support its use in the treatment of serious infections in critically ill patients. SAM demonstrates extensive penetration into many infection sites, supporting its use in a wide range of infection types. Microbiologically, sulbactam has strong intrinsic antibiotic activity against multidrug-resistant (MDR) bacteria, including Acinetobacter baumannii, which supports its use for the treatment of infections mediated by this pathogen. Of some concern, there have been reports showing a decline in susceptibility of some bacteria to SAM. As such, use of lower doses (4/2 g/day), particularly for MDR A. baumannii, has been linked with a 30% reduced success rate in critically ill patients. The therapeutic challenges for ensuring achievement of optimal dosing of SAM result partly from bacterial susceptibility but also from the pharmacokinetic (PK) alterations common to β-lactam agents in critical illness. These PK changes are likely to reduce the ability of standard dosing to achieve the concentrations observed in non-critically ill patients. Optimisation of therapy may be more likely with the use of higher doses, administration by 4 h infusion or by combination therapy, particularly for the treatment of infections caused by MDR pathogens.
Keyword Multidrug resistant
Critically Ill
Pharmacokinetics
Pharmacodynamics
Resistant Acinetobacter Baumannii
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: UQ Centre for Clinical Research Publications
Official 2014 Collection
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 8 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 10 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Sun, 10 Nov 2013, 10:30:36 EST by System User on behalf of Anaesthesiology and Critical Care - RBWH