How to treat severe Acinetobacter baumannii infections.

IF 3.6 3区医学 Q2 INFECTIOUS DISEASES

Current Opinion in Infectious Diseases Pub Date : 2023-12-01 Epub Date: 2023-09-26 DOI:10.1097/QCO.0000000000000974

Emilio Bouza, Patricia Muñoz, Almudena Burillo

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引用次数: 0

Abstract

Purpose of review: To update the management of severe Acinetobacter baumannii infections (ABI), particularly those caused by multi-resistant isolates.

Recent findings: The in vitro activity of the various antimicrobial agents potentially helpful in treating ABI is highly variable and has progressively decreased for many of them, limiting current therapeutic options. The combination of more than one drug is still advisable in most circumstances. Ideally, two active first-line drugs should be used. Alternatively, a first-line and a second-line drug and, if this is not possible, two or more second-line drugs in combination. The emergence of new agents such as Cefiderocol, the combination of Sulbactam and Durlobactam, and the new Tetracyclines offer therapeutic options that need to be supported by clinical evidence.

Summary: The apparent limitations in treating infections caused by this bacterium, the rapid development of resistance, and the serious underlying situation in most cases invite the search for alternatives to antibiotic treatment, the most promising of which seems to be bacteriophage therapy.

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如何治疗严重的鲍曼不动杆菌感染。

综述目的：更新严重鲍曼不动杆菌感染（ABI）的管理，特别是由多重耐药分离株引起的感染。最近的发现：可能有助于治疗ABI的各种抗菌剂的体外活性变化很大，其中许多抗菌剂的活性逐渐降低，限制了目前的治疗选择。在大多数情况下，一种以上药物的组合仍然是可取的。理想情况下，应使用两种活性一线药物。或者，一种一线和一种二线药物，如果不可能的话，两种或两种以上的二线药物联合使用。新药物的出现，如头孢iderocol、舒巴坦和达洛巴坦的联合用药以及新的四环素类药物，提供了需要临床证据支持的治疗选择。摘要：治疗这种细菌引起的感染的明显局限性、耐药性的快速发展以及大多数情况下严重的潜在情况，促使人们寻找抗生素治疗的替代方案，其中最有希望的似乎是噬菌体治疗。

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.