Trimethoprim - Sulfamethoxazole in Combination With Meropenem Orpolymyxin is Effective in Management of Acinetobacter Baumannii Associated Pneumonia and Urinary Tract Infection

Amid Bhujel,Niraj Kumar Keyal,Niru Nepal

doi:10.3126/bjhs.v5i1.29640

Abstract

Acinetobacter baumanniiis a common multidrug resistant bacteria that causes pneumonia and urinary tract infection in intensive care unit and requires dual antibiotic for effective management. There are limited expensive antibiotics that are active against. Acinetobacter baumannii. Trimethoprim - Sulfamethoxazole is a cheap, older and easily available antibiotic that can be used in combination with Meropenem or Polymyxin for treatment to decrease antibiotic resistance. This case presentation of three patients describes the successful treatment of hospital acquired Pneumonia and Urinary Tract Infection by Acinetobacter baumannii with Trimethoprim - Sulfamethoxazole in combination with Meropenem and Polymyxin that lead avoidance of costly drugs and decrease in antibiotic resistance. Antibiotic resistance and lack of newer effective antibiotic against multidrug resistant bacteria like Acinetobacter baumannii is a common problem in intensive care unit. Trimethoprim -Sulfamethoxazole may help in combating this problem.

Highlights

Acinetobacter baumannii is a mul drug resistant (MDR) opportunis c gram nega ve coccobacilli that commonly causeshospital acquired[1] but rarely it may cause community acquired[2] pneumonia, urinary tract infec on, endocardi s, meningi s, wound infec on. It is MDR[3] bacteria that is resistance to most of commonly used an bio cs combina on therapy is used to decrease an bio c resistance and treatment failure.[4]
Culture report of sputum and urine both showed Acinetobacter baumannii sensi ve to Polymyxin B, Colis n and Trimethoprim – Sulfamethoxazole (TMP-SMX)
Pa ent was started on Polymyxin B 1.5 million units intravenously stat and 1 million units intravenously 2 mes a day (Bharat Serums And Vaccines Limited, Mumbai, India) and TMP-SMX (160 + 800 mg) 2 tablet per oral 12 hourly(Medico Remedies Ltd, Mumbai, India) for 10 days

Summary

Introduction

Acinetobacter baumannii is a mul drug resistant (MDR) opportunis c gram nega ve coccobacilli that commonly causeshospital acquired[1] but rarely it may cause community acquired[2] pneumonia, urinary tract infec on, endocardi s, meningi s, wound infec on. Pa ent developed shortness of breath, fever with maximum temperature of 102oF and cough a er eighth day of admission.

Results

Conclusion