title: Optimum treatment strategies for carbapenem-resistant Acinetobacter baumannii bacteremia.
abstract: Carbapenem-resistant Acinetobacter baumannii (CRAB) constitutes an increasing problem worldwide. CRAB bacteremia is associated with a high fatality rate and its optimal treatment has not been established. Early institution of appropriate therapy is shown to improve survival of patients with CRAB bloodstream infection. Regrettably, treatment options are limited. Little information exists about the efficacy of sulbactam for the treatment of CRAB bacteremia. Colistin and tigecycline possess good in vitro activity and represent in many cases the only therapeutic options although clinical data are scarce. The need for a loading dose of colistin has been recently demonstrated to rapidly achieve therapeutic levels. The use of combination therapy is also a matter of debate but current evidence do not support its routine use.
authors: Unidad Clínica de Cuidados Críticos, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
authors: José
authors: J
authors: Garnacho-Montero
authors: Rosario
authors: R
authors: Amaya-Villar
authors: Carmen
authors: C
authors: Ferrándiz-Millón
authors: Ana
authors: A
authors: Díaz-Martín
authors: José María
authors: JM
authors: López-Sánchez
authors: Antonio
authors: A
authors: Gutiérrez-Pizarraya
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy*; D040981:Acinetobacter baumannii / Q000187:drug effects*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy*; D015780:Carbapenems; D003091:Colistin / Q000627:therapeutic use; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005578:Fosfomycin / Q000627:therapeutic use; D006801:Humans; D008826:Microbial Sensitivity Tests; D008911:Minocycline / Q000031:analogs & derivatives / Q000627:therapeutic use; D011113:Polymyxins / Q000627:therapeutic use; D013407:Sulbactam / Q000627:therapeutic use; D000078304:Tigecycline; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D011113:Polymyxins; D005578:Fosfomycin; D000078304:Tigecycline; D008911:Minocycline; D013407:Sulbactam; D003091:Colistin
keywords: Acinetobacter baumannii; bacteremia; carbapenem-resistant; colistin; polymyxin; tigecycline; treatment