Int J Med Sci 2016; 13(10):749-753. doi:10.7150/ijms.16090 This issue Cite
Research Paper
1. Department of Pharmacy, Rakuwakai Otowa Hospital, Kyoto 607-8062, Japan;
2. School of Pharmacy and Pharmaceutical Sciences, Mukogawa Women's University, Nishinomiya 663-8179, Japan;
3. Department of Pharmacy, Kyoto Kujo Hospital, Kyoto 601-8453, Japan;
4. Department of Pharmacy, Rakuwakai Marutamachi Hospital, Kyoto 604-8405, Japan;
5. Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501, Japan;
6. Department of Pharmacokinetics, Kyoto Pharmaceutical University, Kyoto 607-8414, Japan.
Objectives: A retrospective examination was conducted to identify risk factors for in-hospital mortality of elderly patients (65 years or older) treated with the beta-lactam/beta-lactamase inhibitor combination antibiotic, ampicillin/sulbactam (ABPC/SBT).
Methods: Clinical data from 96 patients who were hospitalized with infectious diseases and treated with ABPC/SBT (9 g/day or 12 g/day) were analyzed. Risk factors examined included demographic and clinical laboratory parameters. Parameter values prior to treatment and changes after treatment were compared between survivors and non-survivors.
Results: The study patients had an average age of 81.9±8.4 years (±SD) and body mass index (BMI) of 19.9±4.2 kg/m2. They were characterized by anemia (low hemoglobin and hematocrit levels), inflammation (high leukocyte count, neutrophil count, C-reactive protein level, and body temperature), and hepatic and renal dysfunction (high aspartate aminotransferase, alanine aminotransferase and blood urea nitrogen levels). The BMI of non-survivors, 16.2±2.9 kg/m2, was lower than that of survivors, 20.4±4.1 kg/m2. In addition, the hematological parameters deteriorated more remarkably, inflammation markers were not altered (or the decrease was marginal), and hepatic function was not improved, in non-survivors.
Conclusions: A lower BMI value is a risk factor for in-hospital mortality of elderly patients treated with ABPC/SBT.
Keywords: ampicillin/sulbactam, elderly patients, mortality, body mass index.