What is the optimal antibiotic treatment strategy for carbapenem-resistant Acinetobacter baumannii (CRAB)? A multicentre study in Korea

Seok, Hyeri; Choi, Won Suk; Lee, Shinwon; Moon, Chisook; Park, Dae Won; Song, Joon Young; Cheong, Hee Jin; Kim, Jieun; Kim, Jin Yong; Park, Mi Na; Kim, Yang Ree; Kim, Bongyoung; Pai, Hyunjoo; Jo, Yu Mi

doi:10.1016/j.jgar.2021.01.018

Cited by 18 publications

(39 citation statements)

References 33 publications

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“…Another article was excluded because there were no detailed patient numbers for the monotherapy group and combination therapy group [ 22 ]. Finally, 10 studies were included in the meta-analysis [ 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. The main characteristics of the 10 included studies are shown in Table 1 and Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Our meta-analysis focused on colistin monotherapy versus colistin in combination with meropenem to treat drug-resistant Acinetobacter baumannii infection. This meta-analysis also included three newly published studies that were not included in the previous meta-analyses [ 30 , 31 , 32 ]. Our meta-analysis clearly showed that colistin combined with meropenem was not superior to colistin monotherapy to treat Acinetobacter baumannii infection except with regard to microbiological response.…”

Section: Discussionmentioning

confidence: 99%

“…Nine studies involving 1484 patients (660 with colistin monotherapy, 824 with colistin plus meropenem combination therapy) reported clinical improvement. There was no significant difference in clinical improvement between patients treated with colistin monotherapy and colistin plus meropenem combination therapy [ 23 , 24 , 25 , 26 , 27 , 28 , 30 , 31 , 32 ].…”

Section: Figurementioning

confidence: 99%

“…The overall microbiological response was significantly different between the two groups. The combination therapy patient group had a better microbiological response than the monotherapy patient group [ 24 , 25 , 28 , 31 , 32 ].…”

Section: Figurementioning

confidence: 99%

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Colistin Monotherapy versus Colistin plus Meropenem Combination Therapy for the Treatment of Multidrug-Resistant Acinetobacter baumannii Infection: A Meta-Analysis

Huang

Chen

Tang

2022

JCM

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(1) Introduction: Colistin combination therapy with other antibiotics is a way to enhance colistin activity. The purpose of this meta-analysis was to compare the efficacy and safety of treatment with colistin monotherapy versus colistin plus meropenem combination therapy in patients with drug-resistant Acinetobacter baumannii infection. (2) Methods: All studies were included if they reported one or more of the following outcomes: clinical improvement, complete microbiological response, 14-day mortality, hospital mortality, or nephrotoxicity. (3) Results: Three randomized controlled trials and seven retrospective studies were included in the meta-analysis. Colistin monotherapy has similar rates of clinical improvement, 14-day mortality, hospital mortality, and nephrotoxicity as colistin plus meropenem combination therapy. Regarding complete microbiological response, the colistin plus meropenem combination was better than colistin monotherapy. (4) Discussion: Previous meta-analyses demonstrated heterogeneity in study quality and a lack of evidence supporting the use of colistin-based combination therapy. Our meta-analysis clearly showed that colistin combined with meropenem was not superior to colistin monotherapy for the treatment of Acinetobacter baumannii infection. (5) Conclusions: The efficacy and safety of treatment with colistin monotherapy and that of colistin plus meropenem combination therapy in patients with drug-resistant Acinetobacter baumannii infection were comparable. The majority of the evidence was obtained from nonrandomized studies, and high-quality randomized controlled trials are needed to confirm the role of colistin plus meropenem combination therapy in the treatment of multidrug-resistant Acinetobacter baumannii infection.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

Section: Figurementioning

confidence: 99%

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Colistin Monotherapy versus Colistin plus Meropenem Combination Therapy for the Treatment of Multidrug-Resistant Acinetobacter baumannii Infection: A Meta-Analysis

Huang

Chen

Tang

2022

JCM

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“…In addition, the approval of an improved intravenous formulation in the United States in 2015 facilitated its use in hospitalized patients with serious infections ( 22 – 24 ). Combination therapy with minocycline and various antimicrobials, including colistin and cefiderocol, have also been studied, although there is no consensus about which combinations are the most useful ( 25 – 27 ).…”

Section: Introductionmentioning

confidence: 99%

Minocycline Activity against Unusual Clinically Significant Gram-Negative Pathogens

Shortridge

Arends

Streit

et al. 2021

Antimicrob Agents Chemother

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The minocycline susceptibility of 3,856 isolates including Burkholderia , Achromobacter , Alcaligenes, Aeromonas , and Stenotrophomonas maltophilia from the SENTRY surveillance (2014-2019) were analyzed. The susceptibilities of these species (number; %S) were Achromobacter spp. (n=411; 92.6%), Burkholderia cepacia species complex (n=199; 85.9%), Aeromonas spp. (n=127; 99.2%), Chryseobacterium spp (n=59; 94.9%), Alcaligenes faecalis (n=42; 88.1%) and S. maltophilia (n=2,287; 99.5%). These data suggest that minocycline may be a useful treatment option for infections caused by unusual gram-negative pathogens.

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An overview of sulbactam‐durlobactam approval and implications in advancing therapeutics for hospital‐acquired and ventilator‐associated pneumonia by acinetobacter baumannii‐calcoaceticus complex: A narrative review

Anand,

Verma,

Kaur

et al. 2024

Health Science Reports

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PurposeInfections caused by Acinetobacter baumannii, particularly those resistant to antibiotics such as carbapenem, have become a global health crisis with a significant mortality rate. Hospital‐acquired pneumonia (HAP) and ventilator‐associated pneumonia (VAP) resulting from the A. baumannii‐calcoaceticus (ABC) complex represent a major clinical challenge. This review aimed to understand the approval process, mechanism of action, therapeutic potential, and future implications of sulbactam‐durlobactam therapy (SUL‐DUR).MethodsPubMed, Web of Science, EMBASE, Clinical trials. gov, ICTRP, and CENTRAL were searched for studies on SUL‐DUR for the treatment of hospital‐acquired pneumonia and ventilator‐associated pneumonia. Also, World Health Organization, U.S. Food and Drug Administration, and Centers for Disease Control and Prevention websites were searched for relevant information.ResultsSUL‐DUR, marketed as Xacduro, is a novel pharmaceutical combination that functions as a narrow‐spectrum parenterally administered antibiotic. Sulbactam acts as a β‐lactamase inhibitor, whereas durlobactam protects against degradation by A. baumannii enzymes. A phase 1 trial successfully established the safety and tolerability of SUL‐DUR in patients with normal and mild renal impairment. A phase 2 trial demonstrated the safety and tolerability of SUL‐DUR in a larger population with urinary tract infections. A phase 3 trial showed that SUL‐DUR was non‐inferior to colistin in terms of mortality in A. baumannii‐related VAP, HAP, and bacteremia.ConclusionThe combination of sulbactam and durlobactam is a promising treatment option for HAP and VAP caused by ABC complex.

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What is the optimal antibiotic treatment strategy for carbapenem-resistant Acinetobacter baumannii (CRAB)? A multicentre study in Korea

Cited by 18 publications

References 33 publications

Colistin Monotherapy versus Colistin plus Meropenem Combination Therapy for the Treatment of Multidrug-Resistant Acinetobacter baumannii Infection: A Meta-Analysis

Colistin Monotherapy versus Colistin plus Meropenem Combination Therapy for the Treatment of Multidrug-Resistant Acinetobacter baumannii Infection: A Meta-Analysis

Minocycline Activity against Unusual Clinically Significant Gram-Negative Pathogens

An overview of sulbactam‐durlobactam approval and implications in advancing therapeutics for hospital‐acquired and ventilator‐associated pneumonia by acinetobacter baumannii‐calcoaceticus complex: A narrative review

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