Bouza Emilio, Muñoz Patricia, Burillo Almudena
Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón.
Medicine Department, School of Medicine, Universidad Complutense de Madrid.
Curr Opin Infect Dis. 2023 Dec 1;36(6):596-608. doi: 10.1097/QCO.0000000000000974. Epub 2023 Sep 26.
To update the management of severe Acinetobacter baumannii infections (ABI), particularly those caused by multi-resistant isolates.
The in vitro activity of the various antimicrobial agents potentially helpful in treating ABI is highly variable and has progressively decreased for many of them, limiting current therapeutic options. The combination of more than one drug is still advisable in most circumstances. Ideally, two active first-line drugs should be used. Alternatively, a first-line and a second-line drug and, if this is not possible, two or more second-line drugs in combination. The emergence of new agents such as Cefiderocol, the combination of Sulbactam and Durlobactam, and the new Tetracyclines offer therapeutic options that need to be supported by clinical evidence.
The apparent limitations in treating infections caused by this bacterium, the rapid development of resistance, and the serious underlying situation in most cases invite the search for alternatives to antibiotic treatment, the most promising of which seems to be bacteriophage therapy.
更新严重鲍曼不动杆菌感染（ABI）的管理，尤其是由多重耐药菌株引起的感染。
各种可能有助于治疗ABI的抗菌药物的体外活性差异很大，并且其中许多药物的活性已逐渐降低，限制了当前的治疗选择。在大多数情况下，联合使用一种以上药物仍然是可取的。理想情况下，应使用两种有效的一线药物。或者，使用一种一线药物和一种二线药物，如果无法做到这一点，则联合使用两种或更多种二线药物。新型药物如头孢地尔、舒巴坦和杜洛巴坦的组合以及新型四环素的出现提供了需要临床证据支持的治疗选择。
治疗这种细菌引起的感染存在明显局限性、耐药性迅速发展以及大多数病例中严重的基础状况，促使人们寻找抗生素治疗的替代方法，其中最有前景的似乎是噬菌体疗法。
