Overview
The goal of this clinical trial is to evaluate the efficacy of colistin compared with colistin plus fosfomycin against carbapenem-resistant Acinetobacter baumanii infection in Thailand. The main questions it aims to answer the following main questions:
- Which group has better clinical response at end of treatment
- Which group has better clinical response at 72 hours and micrological cure at 72 hours and at end of treatment
Description
Participants will be randomized in a 1:1 ratio to receive a combination of intravenous colistin plus intravenous fosfomycin (combination group) or colistin alone (monotherapy group) to determine if monotherapy or combination therapy has a better outcome.
Eligibility
Inclusion Criteria:
- ≥ 20 years old patients who have CRAB infections (pneumonia, urinary tract infection, skin and soft tissue infection, bloodstream infection)
- Able to provide informed consent or having a legal proxy who can provide informed consent in case the subject is unable to provide consent on his own
Exclusion Criteria:
- Minimum inhibitory concentration (MIC) of colistin > 2 mg/L
- Complicated infection with inadequate source controlled
- Intracranial infection
- Infective endocarditis
- Intraabdominal infection
- Bone and joint infection
- Allergic to or have contraindication(s) to any treatment regimen in the study
- Polymicrobial infection with Carbapenem-resistant Psuedomonas aeruginosa, Carbapenem-resistant Enterobacterales (CRE), Vancomycin-resistant Enterococcus (VRE)
- Pregnancy
- Previous treatment with colistin or fosfomycin more than 96 hours
- Life expectancy of 24 hour or less
- Refusal to participate in the study
- Hospice treatment