From the Guidelines
The most effective antibiotics for Acinetobacter hemolyticus are typically carbapenems, such as imipenem or meropenem, or colistin, which should be used based on antibiotic susceptibility testing results. Other potentially sensitive antibiotics include:
- Aminoglycosides (e.g., amikacin, gentamicin)
- Fluoroquinolones (e.g., ciprofloxacin, levofloxacin)
- Tetracyclines (e.g., minocycline, tigecycline)
- Sulbactam (often combined with ampicillin) 1 Treatment duration typically ranges from 7 to 14 days, depending on the site and severity of infection. Combination therapy may be necessary in severe cases or for multidrug-resistant strains, but the use of combination therapy with polymyxins and carbapenems is not recommended based on high-certainty evidence from recent studies 1. It's crucial to obtain antibiotic susceptibility testing before initiating treatment, as A. hemolyticus can develop resistance. Empiric therapy should be based on local resistance patterns until susceptibility results are available. The choice of antibiotic should prioritize the patient's quality of life, morbidity, and mortality, and the most recent and highest quality study should guide the decision-making process. In this case, the 2022 study by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) provides the most recent and highest quality evidence for the treatment of Acinetobacter baumannii infections 1. The study recommends against the use of carbapenem-polymyxin combination therapies for CRAB infections and suggests the use of colistin or high-dose tigecycline as alternative treatment options. Therefore, the use of carbapenems or colistin, based on antibiotic susceptibility testing results, is the most appropriate treatment option for Acinetobacter hemolyticus infections.
From the FDA Drug Label
Cefiderocol has shown in vitro activity against subset of isolates of A. baumannii complex that are resistant to meropenem, ciprofloxacin, and amikacin. Cefiderocol demonstrated in vitro activity against a subgroup of A. baumannii containing OXA-23, OXA-24/40, OXA-51, OXA-58, and AmpC. In a neutropenic murine thigh infection model using a humanized dose (2 grams every 8 hours), cefiderocol demonstrated 1log10 reduction in bacterial burden against most ... A. baumannii, ... including some carbapenemase-producing (KPC, OXA-23, OXA-24/40, OXA-58) isolates with MICs of ≤ 4 mcg/mL to cefiderocol. In an immunocompetent rat pneumonia model, reduction in bacterial counts in the lungs of animals infected with ... A. baumannii with MICs ≤ 2 mcg/mL, ... including carbapenemase-producing (KPC, NDM, and IMP) isolates was observed using humanized cefiderocol drug exposure.
Sensitive antibiotics for Acinetobacter (A. baumannii) hemolyticus infection include:
- Cefiderocol 2 as it has shown in vitro activity against A. baumannii complex, including some carbapenemase-producing isolates.
From the Research
Sensitive Antibiotics for Acinetobacter (A. baumannii) hemolyticus Infection
- The following antibiotics have been found to be effective against Acinetobacter baumannii infections:
- Combination antimicrobial therapy is often used to treat infections caused by multidrug-resistant Acinetobacter baumannii, and has been found to be effective in some cases 4, 5, 7
- The combination of colistin and meropenem has been found to be effective against carbapenem-resistant Acinetobacter baumannii infections, and may be a better option than the combination of colistin and imipenem 6
- The addition of vancomycin to colistin and meropenem has been found to be effective against multidrug-resistant Acinetobacter baumannii infections, and may be a useful therapeutic option in some cases 7