What antibiotic is effective against Acinetobacter radioresistens infection?

From the Guidelines

For Acinetobacter radioresistens infections, carbapenems such as imipenem (500 mg IV every 6 hours) or meropenem (1 gram IV every 8 hours) are typically first-line treatments, as suggested by the most recent guidelines 1. When considering treatment options, it's essential to note that Acinetobacter radioresistens typically shows better antibiotic susceptibility compared to its more notorious relative A. baumannii. However, antibiotic susceptibility testing is crucial before finalizing treatment as resistance patterns can vary 1. Some key points to consider when treating Acinetobacter radioresistens infections include:

• Treatment duration is generally 7-14 days depending on infection severity and site
• Combination therapy with a beta-lactam antibiotic like piperacillin-tazobactam (4.5 grams IV every 6 hours) plus an aminoglycoside such as amikacin (15-20 mg/kg IV once daily) may be effective
• For severe infections, consider consulting with an infectious disease specialist
• Ensure adequate dosing adjustments for patients with renal or hepatic impairment
• The choice of antibiotic should be guided by local resistance patterns, infection site, and patient-specific factors such as allergies and comorbidities It's also important to note that the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guidelines suggest that carbapenem-resistant Acinetobacter baumannii (CRAB) can be treated with sulbactam or polymyxin, but the evidence for these recommendations is limited 1. In addition, the 2022 guidelines for the treatment of infections due to multidrug-resistant organisms recommend considering the local epidemiology and using antimicrobial agents that may not yet be available in all regions 1. Overall, the treatment of Acinetobacter radioresistens infections requires careful consideration of the patient's specific situation and the local resistance patterns, and should be guided by the most recent and highest-quality evidence available 1.

From the FDA Drug Label

Amikacin has been shown to be active against the following bacteria, both in vitro and in clinical infections (see INDICATIONS AND USAGE) Gram-Positive Bacteria Staphylococcus species Gram-Negative Bacteria Pseudomonas species Escherichia coli Proteus species (indole-positive and indole-negative) Klebsiella species Enterobacter species Serratia species Acinetobacter species

The antibiotic amikacin is effective against Acinetobacter infection, including Acinetobacter radioresistens, as it is active against Acinetobacter species in general 2.

From the Research

Effective Antibiotics Against Acinetobacter radioresistens Infection

There are no specific studies provided that directly address the effectiveness of antibiotics against Acinetobacter radioresistens infection. However, based on the provided evidence, the following antibiotics have been found to be effective against other Acinetobacter species:

• Carbapenems (imipenem, meropenem, doripenem) [ 3, 4 ]
• Polymyxins (colistin) [ 3, 4, 5, 6, 7 ]
• Sulbactam [ 3, 4, 5, 7 ]
• Tigecycline [ 3, 4, 5, 7 ]
• Aminoglycosides (amikacin) [ 4, 7 ]

Combination Therapy

Combination therapy has been suggested as a potential treatment option for Acinetobacter infections, including:

• Colistin plus imipenem or meropenem [ 5, 7 ]
• Colistin plus sulbactam [ 5 ]
• Colistin plus tigecycline [ 5, 7 ]
• Imipenem plus tigecycline [ 7 ]
• Imipenem plus amikacin [ 7 ]
• Imipenem plus ampicillin/sulbactam [ 7 ]

Key Considerations

• The choice of antibiotic should be guided by the susceptibility patterns of the specific Acinetobacter species [ 4 ]
• Combination therapy may be necessary to achieve optimal clinical outcomes [ 3, 4, 6 ]
• Early institution of appropriate antimicrobial therapy is crucial to improve survival in patients with Acinetobacter infections [ 6 ]