A Combination Strategy of Ceftriaxone, Sulbactam and Disodium Edetate for the Treatment of Multi-Drug Resistant (MDR) Septicaemia: A Retrospective, Observational Study in Indian Tertiary Care Hospital

Abstract

Introduction: Previous studies have suggested the use of rational combination therapy for the treatment of multi-drug resistant (MDR) infections. An antibiotic adjuvant entity (AAE) of ceftriaxone, sulbactam and disodium edetate (Elores) was approved for multi-drug resistant infections in India. Aim: This study was designed to investigate the efficacy and safety of this AAE in patients with sepsis due to extended spectrum beta lactamse (ESBL) and metallo-beta lactamase (MBL) producing pathogens. Materials and Methods: A retrospective observational study was conducted in patients admitted in intensive care unit (ICU) at tertiary health care site in India, with enrollment from 24 March, 2012 to 7 Aug, 2012. Patients eligible for enrollment had clear infection of bacterial septicaemia, were aged 12-65 years, and were considered for treatment with Cephalosporins categories of antibiotics. Results: Total 18 patients were included in the study and all assigned to combination of ceftriaxone, sulbactam and disodium edetate. Complete clinical cure in terms of relief and no-disease symptoms had observed in 15 (83.3%) subjects, however 3 (16.6%) showed treatment failure (TF). Similarly for bacteriological eradication response, 15 (83.3%) patients displayed complete bacteriological eradication response and 03 (16.6%) subjects showed TF. No serious side effect was observed during the study. Conclusion: This study recommends the use of combination of ceftriaxone, sulbactam and disodium edetate (EDTA) for the treatment of MDR septicaemia associated with ESBL and MBL producing microbes.

Keywords

• antibiotic adjuvant entity
• bacterial septicaemia
• combination therapy