Efficacy of Triple vs Double drug regimens with at least two sensitive antibiotics on the outcome of patients infected with ventilator-associated pneumonia due to carbepenam-resistant Acinetobacter Baumannii: A randomised controlled study.

The present randomised controlled single-blinded study shall be conducted in adult intensive care at AIIMS JODHPUR after obtaining written informed consent from the patients/patient’s relatives and approval from the institutional ethical committee. The study shall be prospectively registered with a clinical trial registry. Adult patients admitted to the intensive care unit for the duration of our study and meeting our inclusion criterion shall be included in the study. They shall be randomised into two groups using the block randomisation technique where one group will receive dual therapy while the other will receive triple therapy containing at least two sensitive drugs in each. The dual therapy will receive either minocycline 200mg bd with sulbactam high dose if sensitive to minocycline or polymyxin with high dose sulbactam if minocycline resistant. The triple therapy regimen will receive minocycline 200mg bd with polymyxin and sulbactam irrespective of minocycline sensitivity.

The baseline APACHE 2 score and SOFA score at treatment initiation and 48 hours after initiation shall be measured. Crossover from dual to triple therapy will be considered if SOFA rises more than 2 post-treatment initiation or persistence of microbiological positivity at day 4 from treatment initiation.