Potentially effective antimicrobial treatment for pneumonia caused by isolates of carbapenem-resistant and extensively drug-resistant Acinetobacter baumannii complex species: what can we expect in the future?

Autor:	Jean SS; Department of Pharmacy, College of Pharmacy and Health Care, Tajen University, Pingtung, Taiwan.; Departments of Internal Medicine and Critical Care Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan., Liu CY; Department of Infectious Diseases and Department of Hospitalist, Far Eastern Memorial Hospital, New Taipei City, Taiwan., Huang TY; Department of Pharmacy, Min-Sheng General Hospital, Taoyuan, Taiwan., Lai CC; Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.; School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung, Taiwan., Liu IM; Department of Pharmacy, College of Pharmacy and Health Care, Tajen University, Pingtung, Taiwan., Hsieh PC; Department of Pharmacy, College of Pharmacy and Health Care, Tajen University, Pingtung, Taiwan., Hsueh PR; Departments of Laboratory Medicine and Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan.; School of Medicine, China Medical University, Taichung, Taiwan.; Ph.D Program for Aging, School of Medicine, China Medical University, Taichung, Taiwan.; Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Jazyk:	angličtina
Zdroj:	Expert review of anti-infective therapy [Expert Rev Anti Infect Ther] 2024 Dec; Vol. 22 (12), pp. 1171-1187. Date of Electronic Publication: 2024 Oct 09.
DOI:	10.1080/14787210.2024.2412637
Abstrakt:	Introduction: Acinetobacter baumannii complex (Abc) is currently a significant cause of difficult-to-treat pneumonia. Due to the high prevalence rates of carbapenem- and extensively drug-resistant (CR, XDR) phenotypes, limited antibiotic options are available for the effective treatment of pneumonia caused by CR/XDR-Abc. Areas Covered: In vitro susceptibility data, relevant pharmacokinetic profiles (especially the penetration ratios from plasma into epithelial-lining fluid), and pharmacodynamic indices of key antibiotics against CR/XDR-Abc are reviewed. Expert Opinion: Doubling the routine intravenous maintenance dosages of conventional tigecycline (100 mg every 12 h) and minocycline (200 mg every 12 h) might be recommended for the effective treatment of pneumonia caused by CR/XDR-Abc. Nebulized polymyxin E, novel parenteral rifabutin BV100, and new polymyxin derivatives (SPR206, MRX-8, and QPX9003) could be considered supplementary combination options with other antibiotic classes. Regarding other novel antibiotics, the potency of sulbactam-durlobactam (1 g/1 g infused over 3 h every 6 h intravenously) combined with imipenem-cilastatin, and the β-lactamase inhibitor xeruborbactam, is promising. Continuous infusion of full-dose cefiderocol is likely an effective treatment regimen for CR/XDR-Abc pneumonia. Zosurabalpin exhibits potent anti-CR/XDR-Abc activity in vitro, but its practical use in clinical therapy remains to be evaluated. The clinical application of antimicrobial peptides and bacteriophages requires validation.
Databáze:	MEDLINE
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