Iovleva Alina, Fowler Vance G, Doi Yohei
Center for Innovative Antimicrobial Therapy, Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
Drugs. 2025 Jan;85(1):21-40. doi: 10.1007/s40265-024-02104-6. Epub 2024 Nov 28.
Carbapenem-resistant Acinetobacter baumannii has been associated with over three hundred thousand annual deaths globally. It is resistant to most available antibiotics and associated with high morbidity and mortality. No global consensus currently exists for treatment strategies that balance safety and efficacy because of heterogeneity of treatment regimens in current clinical practice and scarcity of large-scale controlled studies arising from difficulties in establishing robust clinical outcomes. This review outlines the epidemiology and resistance mechanisms of carbapenem-resistant A. baumannii, then summarizes available clinical data on each approved agent with activity against this pathogen. Emerging treatment options such as cefiderocol and sulbactam-durlobactam show promise, but their success hinges on comprehensive clinical validation and access in regions most impacted by this pathogen. New therapeutic modalities that are in various stages of clinical development are also discussed.
耐碳青霉烯类鲍曼不动杆菌每年在全球导致超过30万人死亡。它对大多数现有抗生素耐药,并与高发病率和死亡率相关。由于当前临床实践中治疗方案的异质性以及因难以建立可靠的临床结果而导致大规模对照研究稀缺,目前对于平衡安全性和有效性的治疗策略尚无全球共识。本综述概述了耐碳青霉烯类鲍曼不动杆菌的流行病学和耐药机制,然后总结了每种对该病原体有活性的获批药物的现有临床数据。新型治疗选择如头孢地尔和舒巴坦-度洛巴坦显示出前景,但它们的成功取决于全面的临床验证以及在受该病原体影响最严重地区的可及性。还讨论了处于临床开发不同阶段的新治疗方式。