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Elmira Niknami,1 Ilad Alavi Darazam,2,3 Arash Mahboubi,4 Minoosh Shabani,2,3 Jamshid Salamzadeh,1 Zahra Sahraei1 1Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 3Department of Infectious Diseases and Tropical Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 4Department of Pharmaceutics, Food Safety Research Center, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, IranCorrespondence: Zahra Sahraei, Email zahra.sahraee@yahoo.comPurpose: Ventilator-associated pneumonia (VAP) caused by multidrug-resistant (MDR) Acinetobacter baumannii is associated with high morbidity and mortality, and optimal antimicrobial dosing strategies remain uncertain. Although ampicillin-sulbactam is increasingly used for MDR Acinetobacter baumannii infections, limited clinical data exist regarding the efficacy and safety of different dosing regimens when used as part of combination therapy. This study aimed to compare the clinical outcomes of low- versus high-dose ampicillin-sulbactam in combination of meropenem and colistin in patients with MDR Acinetobacter baumannii associated VAP.Patients and Methods: In this randomized clinical trial, patients with MDR Acinetobacter baumannii associated VAP admitted to the intensive care unit were allocated to receive either low-dose ampicillin-sulbactam (6 g IV every 6Â h; total 24 g/day) or high-dose ampicillin-sulbactam (9 g IV every 6Â h; total 36 g/day). Meropenem and colistin were administered concomitantly in both groups, as they remain commonly used standard therapies for severe MDR infections despite increasing resistance and toxicity concerns. Clinical outcomes, including fever duration, pulmonary secretions, Clinical Pulmonary Infection Score (CPIS), duration of mechanical ventilation, length of ICU and hospital stay, mortality, ... |