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ORIGINAL ARTICLE
Year : 2016  |  Volume : 19  |  Issue : 1  |  Page : 5-10

A retrospective comparative study to evaluate the use of a new beta-lactam + beta-lactamase inhibitor (ceftriaxone + sulbactam + disodium edetate) in comparison to meropenem in the management of gram-negative bacterial sepsis


1 Department of Critical Care and Respiratory Medicine, Metro Heart Institute with Multispeciality, Faridabad, Haryana, India
2 Department of Critical Care Medicine, Metro Heart Institute with Multispeciality, Faridabad, Haryana, India
3 Department of Pathology, Metro Heart Institute with Multispeciality, Faridabad, Haryana, India
4 Department of Microbiology, Metro Heart Institute with Multispeciality, Faridabad, Haryana, India

Correspondence Address:
Vijay Kumar Agrawal
House No 966, First Floor, Sector 37, Faridabad, Haryana
India
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DOI: 10.4103/1119-0388.172068

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Introduction and Objective: Gram-negative bacterial sepsis and anti-microbial resistance are global health concerns. The present study is a comparative retrospective analysis of the outcome of two antibacterial therapies (Ceftriaxone + Sulbactam + adjuvant Disodium edetate [FDC] and Meropenem) used for management of patients suffering from gram-negative bacterial sepsis. Materials and Methods: Both the therapies (FDC or Meropenem) were initiated empirically on the basis of clinical presentation of the patients and treating physician's decision and continued based on the results of the in vitro microbiological susceptibility testing pattern and clinical outcome. Results: 70 patients with known Gram-negative bacterial infections showing sensitivity to FDC and Meropenem were included in the study. Fifty-seven (81.42%) out of 70 cultures isolated from the patients showed susceptibility towards FDC, whereas the isolates showed comparatively lower susceptibility (45 [64.28%]) towards Meropenem. Twenty (54.05%) out of 37 patients treated with FDC were cured, while the remaining patients achieved clinical success with FDC + Colistin combination therapy. On the other hand, only 11 (33.33%) out of 33 patients to whom Meropenem was given empirically were cured, and the remaining 22 patients required Meropenem and Colistin combination therapy to achieve clinical cure. Conclusion: This new FDC exhibits better antimicrobial susceptibility than Meropenem and a better efficacy in gram-negative sepsis management. This new FDC in combination with Colistin can be used to treat severe sepsis patients, which often fails to respond to monotherapy. This new FDC and Colistin can be an effective alternate therapy to Meropenem and Colistin.


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