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Treatment Approaches for Carbapenem-ResistantAcinetobacter baumannii Infections

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Abstract

Carbapenem-resistantAcinetobacter 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-resistantA. 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.

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Authors and Affiliations

  1. Center for Innovative Antimicrobial Therapy, Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Alina Iovleva & Yohei Doi

  2. Department of Medicine, Duke University School of Medicine, Durham, NC, USA

    Vance G. Fowler Jr.

  3. Duke Clinical Research Institute, Durham, NC, USA

    Vance G. Fowler Jr.

  4. Departments of Microbiology and Infectious Diseases, Fujita Health University, Toyoake, Aichi, Japan

    Yohei Doi

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  1. Alina Iovleva

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  2. Vance G. Fowler Jr.

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  3. Yohei Doi

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Correspondence toYohei Doi.

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Funding

This work was supported in whole or in part with federal funds from the National Institutes of Health: KL2 TR001856 (AI), R01 AI104895 (YD), and R01 AI165671 (VGF).

Conflict of interest

AI declares no relevant conflicts of interest. VGF reports the following: Grants/research support: Astra Zeneca; MedImmune; Merck; ContraFect, Karius, Genentech, Regeneron, Basilea. Paid Consultant: Astra Zeneca; GSK; Armata, Debiopharm; Genentech; Basilea, Affinergy, Janssen, ContraFect, Destiny. Royalties: UptoDate.Stock Options: ArcBio, Valanbuio. Patent pending: sepsis diagnostics. YD reports the following: Paid Consultant: Gilead Sciences; Moderna; GSK; Pfizer; AbbVie; Shionogi; Meiji Seika Pharma.

Author Contributions

AI conceived the idea for the article, performed the literature search and drafted the manuscript. VGF and YD critically revised the work.

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Iovleva, A., Fowler, V.G. & Doi, Y. Treatment Approaches for Carbapenem-ResistantAcinetobacter baumannii Infections.Drugs85, 21–40 (2025). https://doi.org/10.1007/s40265-024-02104-6

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