From clinical trials to daily practice: how to adequately administer sulbactam-durlobactam? alone or combined with imipenem?

IF 4.5 3区医学 Q2 INFECTIOUS DISEASES

Current Opinion in Infectious Diseases Pub Date : 2025-12-01 Epub Date: 2025-10-27 DOI:10.1097/QCO.0000000000001148

Cecilia Bonazzetti, Maddalena Giannella, Renato Pascale

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Abstract

Purpose of review: Sulbactam-durlobactam (SUL-DUR) is a novel β-lactam/β-lactamase inhibitor combination recently approved for carbapenem-resistant Acinetobacter baumannii (CRAB) infections. This review summarizes current knowledge on the optimal use of SUL-DUR, whether administered alone or in combination with carbapenems, particularly imipenem.

Recent findings: Data from registrational trial demonstrate that SUL-DUR is an effective and well tolerated treatment option for CRAB severe infections. However, this trial assessed the efficacy of SUL-DUR exclusively in combination with imipenem. Real-world reports have described successful use of SUL-DUR in combination with carbapenems and other agents, particularly in complex or drug-resistant cases. Microbiological data suggest synergistic effects between SUL-DUR and carbapenems due to complementary inhibition of different penicillin-binding proteins.

Summary: Combination therapy of SUL-DUR with carbapenems remains the preferred strategy in critically ill or high-risk patients. Future trials should specifically evaluate the comparative efficacy of monotherapy vs. combination regimens and establish which could be the best companion in the treatment of CRAB infections.

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从临床试验到日常实践：舒巴坦-杜氯巴坦如何充分给药？单独使用还是与亚胺培南联合使用？

综述目的：舒巴坦-杜罗巴坦（su -dur）是最近批准用于耐碳青霉烯鲍曼不动杆菌（CRAB）感染的新型β-内酰胺/β-内酰胺酶抑制剂组合。这篇综述总结了目前关于sol - dur的最佳使用的知识，无论是单独给药还是与碳青霉烯类，特别是亚胺培南联合给药。最新发现：注册试验的数据表明，sulr - dur是治疗螃蟹严重感染的有效且耐受性良好的治疗选择。然而，该试验仅评估了su - dur与亚胺培南联合使用的疗效。现实世界的报告已经描述了成功地将sol - dur与碳青霉烯类和其他药物联合使用，特别是在复杂或耐药病例中。微生物学数据表明，由于不同的青霉素结合蛋白的互补抑制，su - dur和碳青霉烯类之间存在协同效应。总结：在危重或高危患者中，硫脲- dur联合碳青霉烯类药物仍然是首选的治疗策略。未来的试验应专门评估单药治疗与联合治疗方案的比较疗效，并确定哪一种可能是治疗螃蟹感染的最佳伴侣。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Infectious Diseases 医学-传染病学

CiteScore

6.70

自引率

2.60%

发文量

121

审稿时长

6-12 weeks

期刊介绍： This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on two topics, every issue of Current Opinion in Infectious Disease delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as HIV infection and AIDS; skin and soft tissue infections; respiratory infections; paediatric and neonatal infections; gastrointestinal infections; tropical and travel-associated diseases; and antimicrobial agents.