Clinical Effectiveness of Tetracycline-Class Agents Based Regimens in Patients With Carbapenem-Resistant Acinetobacter baumannii Bacteremia: A Single-Center Retrospective Cohort Study

J Korean Med Sci. 2023 Aug 28;38(34):e263. doi: 10.3346/jkms.2023.38.e263.

Abstract

This study evaluated the clinical outcome of carbapenem-resistant Acinetobacter baumannii (CRAB) bacteremia and the clinical effectiveness of tetracyclines-based therapy. In a retrospective cohort study over 5 years period, 108 patients were included in the study. The overall 30-day mortality rate was 71.4%. Pitt's bacteremia score (PBS) (adjusted hazard ratio [aHR], 1.32; 95% confidence interval [CI], 1.22-1.42 per 1-point), colistin-single regimens (aHR, 0.34; 95% CI, 0.17-0.69), and tetracyclines single/tetracyclines-colistin combination regimens (aHR, 0.18; 95% CI, 0.07-0.48) were independently associated with 30-day mortality. Among patients with a PBS < 6, only tetracycline-containing regimens were associated with decreased mortality. Among patients receiving appropriate definite antimicrobials, the tetracyclines-colistin combination (7 of 7, 100%) tended to a higher 30-day survival rate compared to a tetracycline (7 of 12, 57.1%) or colistin single regimen (10 of 22, 41.6%, P = 0.073). Our findings suggest tetracyclines might be effective for treating CRAB infections when combined with colistin.

Keywords: Acinetobacter baumannii; Carbapenem-Resistance; Extensively Drug Resistant; Minocycline; Tetracyclines; Tigecycline.

MeSH terms

  • Acinetobacter baumannii*
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia* / drug therapy
  • Carbapenems / therapeutic use
  • Colistin / therapeutic use
  • Humans
  • Retrospective Studies
  • Tetracycline / therapeutic use
  • Tetracyclines / therapeutic use
  • Treatment Outcome

Substances

  • Tetracycline
  • Colistin
  • Anti-Bacterial Agents
  • Tetracyclines
  • Carbapenems