EFFICACY OF SULBACTAM-AMPICILLIN COMBINATION IN THE TREATMENT OF SEVERE COMMUNITY-ACQUIRED PNEUMONIA

A multicenter study was performed on 136 patients with severe communit y-acquired pneumonia. A protected brush sample (PBS) was performed at hospital admission in all patients. They received sulbactam-ampicillin combination administered continously IV at a dose of sulbactam 50 mg/ kg/day and ampicillin 100 mg/kg/day. PBS culture was negative in 71 pa tients and among them, 6 had positive blood culture. PBS culture was p ositive (greater than or equal to 10(3) ufc/ml) in 65 patients. Effica cy of sulbactam-ampicillin combination was evaluated in 71 patients : 65 with positive PBS and 6 with negative PBS and positive blood cultur e. Among these 71 patients, 11 were excluded : protocole violation (n = 7) and resistance of isolated organisms to the study drug (n = 4). A mong the 60 remaining patients, length of treatment was 9.1 +/- 2.8 da ys. Results were as follows : success was obtained in 47 patients (78 %) and failure in 13 patients (22 %). Causes of failure were : side ef fect (n = 2) : allergia (n = I), erythrodermia (n = 1) and in 11 cases failure was due to the persistance or aggravation of the pulmonary in fection and 6 patients died. Failure of treatment was statistically co rrelated to the initial severity of illness. We conclude that sulbactu m-ampicillin combination can be proposed to patients with severe commu nity-acquired pneumonia.