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Curr Opin Infect Dis ; 37(2): 137-143, 2024 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-38179988

RESUMEN

PURPOSE OF REVIEW: The purpose of this review is to briefly summarize the challenges associated with the treatment of pneumonia caused by carbapenem-resistant Acinetobacter baumannii (CRAB), discuss its carbapenem-resistance, and review the literature supporting the current treatment paradigm and therapeutic options. RECENT FINDINGS: In a multicenter, randomized, and controlled trial the novel ß-lactam-ß-lactamase inhibitor sulbactam-durlobactam was compared to colistin, both in addition to imipenem-cilastatin. The drug met the prespecified criteria for noninferiority for 28-day all-cause mortality while demonstrating higher clinical cure rates in the treatment of CRAB pneumonia. In an international, randomized, double-blind, placebo controlled trial colistin monotherapy was compared to colistin combined with meropenem. In this trial, combination therapy was not superior to monotherapy in the treatment of drug-resistant gram-negative organisms including CRAB pneumonia. SUMMARY: CRAB pneumonia is a preeminent public health threat without an agreed upon first line treatment strategy. Historically, there have been drawbacks to available treatment modalities without a clear consensus on the first-line treatment regimen. CRAB pneumonia is a top priority for the continued development of antimicrobials, adjuvant therapies and refinement of current treatment strategies.


Asunto(s)
Infecciones por Acinetobacter , Acinetobacter baumannii , Neumonía , Humanos , Antibacterianos , Colistina/uso terapéutico , Carbapenémicos/farmacología , Carbapenémicos/uso terapéutico , Infecciones por Acinetobacter/tratamiento farmacológico , Inhibidores de beta-Lactamasas/uso terapéutico , Neumonía/tratamiento farmacológico , Pruebas de Sensibilidad Microbiana , Ensayos Clínicos Controlados Aleatorios como Asunto , Estudios Multicéntricos como Asunto
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