From the Guidelines
Achromobacter pneumonia treatment should initially involve a combination of antibiotics, with ceftazidime/avibactam or meropenem/vaborbactam being potential first-line options.
- The choice between these two options may depend on the site of infection, with meropenem/vaborbactam potentially being more suitable for pneumonia due to its intrapulmonary penetration properties 1.
- Local epidemiology and the emergence of resistance should also be considered when selecting an antibiotic regimen 1.
- Imipenem/relebactam and cefiderocol may be considered as alternative options, although clinical studies on their efficacy in Achromobacter pneumonia are limited 1.
- The duration of treatment should be individualized based on the severity of the infection and the patient's clinical response, but is typically in the range of 14 to 21 days.
- It is essential to monitor the patient's response and adjust the treatment based on clinical judgment and microbiological results, including susceptibility testing.
- Ceftazidime/avibactam (2.5 grams every 8 hours) or meropenem/vaborbactam could be considered as part of the initial treatment regimen, with the possibility of adjusting or adding other antibiotics based on the patient's response and susceptibility testing results 1.
From the Research
Initial Successful Treatment of Achromobacter Pneumonia
The initial successful treatment of Achromobacter pneumonia can be supported by the following evidence:
- A study published in 2023 2 found that Achromobacter spp. showed 100% susceptibility to minocycline and piperacillin-tazobactam, and a favorable outcome was seen in 78.6% of individuals with timely institution of antibiotics and proper diagnosis.
- A review of non-cystic fibrosis achromobacterial lung infections published in 2015 3 suggested that extended-spectrum penicillins and cephalosporins, such as ticarcillin, piperacillin, and cefoperazone, are effective treatments for achromobacterial lung infections.
- A retrospective review of Achromobacter species and antibiotic treatments in patients with primary ciliary dyskinesia published in 2021 4 found that successful eradication was achieved in 62% of patients, and the course of lung function was significantly worse during persistent Achromobacter species infection.
- A study on the treatment of Achromobacter ventilator-associated pneumonia in critically ill trauma patients published in 2018 5 found that the primary outcome of clinical success was achieved in 32 of 37 episodes (87%), and microbiological success was seen in 21 of 28 episodes (75%).
Antibiotic Treatments
The following antibiotic treatments have been found to be effective against Achromobacter pneumonia:
- Minocycline and piperacillin-tazobactam 2
- Extended-spectrum penicillins and cephalosporins, such as ticarcillin, piperacillin, and cefoperazone 3
- Imipenem/cilastatin, cefepime, or trimethoprim/sulfamethoxazole 5
Patient Outcomes
The patient outcomes for Achromobacter pneumonia treatment have been found to be: