TREATMENT OF MULTIDRUG-RESISTANT ACINETOBACTER-BAUMANNII MENINGITIS WITH AMPICILLIN SULBACTAM/

The clinical features and the outcomes of eight cases of nosocomial Ac inetobacter baumannii meningitis treated with ampicillin/sulbactam are reported. All the patients had fever, neck stiffness or meningeal sig ns, and a low consciousness level, and in their cerebrospinal fluid (C SF), pleocytosis, a low glucose level, and an elevated protein level w ere noted. For all CSF isolates of A. baumannii, the MIC of ampicillin /sulbactam was less than or equal to 8/4 mu g/mL. The MICs of sulbacta m by microdilution in two cases were 4 mu g/mL. All isolates were resi stant to cefotaxime, ceftriaxone, ceftazidime, ureidopenicillins, cipr ofloxacin, and gentamicin. Seven isolates were resistant to imipenem. A. baumannii was isolated from other samples in seven episodes. All pa tients were treated with ampicillin/sulbactam (seven with 2 g/1 g ever y 6 hours and one with 2 g/1 g every 8 hours). Six patients were cured and two patients died of meningitis. There were no side effects with the ampicillin/sulbactam treatment. Ln conclusion, ampicillin/sulbacta m may be effective as therapy for meningitis caused by A, baumanii res istant to imipenem and other beta-lactam drugs.