The University of Louisville Journal of Respiratory Infections


Acinetobacter baumannii is a significant pathogen in healthcare settings (specifically prominent in healthcare- and ventilator-associated pneumonia) due primarily to its virulence and resistance to a wide variety of antimicrobial drug classes, including carbapenems (CRAB). Existing therapies (notably polymyxins, minocycline, tigecycline, amikacin, and sulbactam) often result in suboptimal tissue concentrations, high rates of toxicity, and increasing rates of resistance. Although utilizing combinations of antibiotics (specifically those containing colistin) have been employed, results have been mixed, and control trials are lacking. Eravacycline is a novel tetracycline with an improved pharmacokinetic profile and more potent activity against A. baumannii relative to tigecycline. Cefiderocol has a unique mechanism of action that has performed well in vitro against multidrug-resistant (MDR) and CRAB isolates. Limited clinical data exists with each of these agents. Other novel antimicrobials are still in early phase clinical trials (ETX2514/sulbactam, TP-271, TP-6076, VNRX-5133/cefepime, cefepime/zidebactam, AIC-499, GSK3342830, and SPR741) while further research is underway for non-antibiotic approaches, specifically monoclonal antibodies and bacteriophage therapies.


The authors received no specific funding for this work



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