Evaluation Of The Effectiveness Of Ampicillin-Sulbactam In The Treatment Of Aspiration Pneumonia In Patients With Opioid Overdose: A Randomized Controlled Clinical Trial

Background and aim: Aspiration pneumonia is one of complications of overdose requiring timely appropriate treatment. The aim of this study was to evaluate the effectiveness of Ampicillin/Sulbactam compared to our usual regimen ceftriaxone + clindamycin in the treatment of aspiration pneumonia opioid-poisoned patients. Methods: In a randomized controlled clinical trial, opioid-poisoned patients with aspiration pneumonia were randomly divided into experimental and control groups to receive ampicillin-sulbactam 3 g IV every 6 hours (experimental group) and ceftriaxone 1 g IV every 12 hours + Clindamycin 600 mg IV every 8 hours (control group) followed by co-amoxiclav 625 mg every 8 hours and cefixime 400 mg once daily + clindamycin 600 mg every 8 hours in experimental and control groups, respectively, to complete a 7-day course of therapy. White blood cell count and temperature (axillary) at baseline and the 3rd day of the intervention as well as the outcome of treatment at the 3rd day of intervention, defined as either complete response, partial response, or failure, were evaluated and recorded for all patients. Results: Except for the number of cases of leukocytosis on the third day of the intervention which was lower in the control group (5 patients, 26.30%) than the experimental group (13 patients, 68.40%) (P = 0.020), no significant difference was observed between the two groups regarding other outcome variables. Clinical response was similar between the groups, so that 10.50% and 63.20% of patients in experimental group as well as 21.10% and 47.4% of patients in control group had complete and partial response, respectively (P = 0.550). Conclusion: ampicillin-sulbactam is an effective antibiotic for the treatment of aspiration pneumonia in patients with opioid overdose, in which case it has the same efficacy as the two-drug regimen of ceftriaxone + clindamycin.