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Review
. 2025 Jan;85(1):21-40.
doi: 10.1007/s40265-024-02104-6. Epub 2024 Nov 28.

Treatment Approaches for Carbapenem-Resistant Acinetobacter baumannii Infections

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Review

Treatment Approaches for Carbapenem-Resistant Acinetobacter baumannii Infections

Alina Iovleva et al. Drugs. 2025 Jan.

Abstract

Carbapenem-resistant Acinetobacter baumannii has been associated with over three hundred thousand annual deaths globally. It is resistant to most available antibiotics and associated with high morbidity and mortality. No global consensus currently exists for treatment strategies that balance safety and efficacy because of heterogeneity of treatment regimens in current clinical practice and scarcity of large-scale controlled studies arising from difficulties in establishing robust clinical outcomes. This review outlines the epidemiology and resistance mechanisms of carbapenem-resistant A. baumannii, then summarizes available clinical data on each approved agent with activity against this pathogen. Emerging treatment options such as cefiderocol and sulbactam-durlobactam show promise, but their success hinges on comprehensive clinical validation and access in regions most impacted by this pathogen. New therapeutic modalities that are in various stages of clinical development are also discussed.

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Conflict of interest statement

Declarations. Funding: This work was supported in whole or in part with federal funds from the National Institutes of Health: KL2 TR001856 (AI), R01 AI104895 (YD), and R01 AI165671 (VGF). Conflict of interest: AI declares no relevant conflicts of interest. VGF reports the following: Grants/research support: Astra Zeneca; MedImmune; Merck; ContraFect, Karius, Genentech, Regeneron, Basilea. Paid Consultant: Astra Zeneca; GSK; Armata, Debiopharm; Genentech; Basilea, Affinergy, Janssen, ContraFect, Destiny. Royalties: UptoDate. Stock Options: ArcBio, Valanbuio. Patent pending: sepsis diagnostics. YD reports the following: Paid Consultant: Gilead Sciences; Moderna; GSK; Pfizer; AbbVie; Shionogi; Meiji Seika Pharma. Author Contributions: AI conceived the idea for the article, performed the literature search and drafted the manuscript. VGF and YD critically revised the work. Ethics approval, informed consent and data availability: Ethics approval, informed consent and data availability are not applicable for this review.

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