How to Treat Carbapenem-Resistant Acinetobacter baumannii Infections: Current Knowledge and Personal Viewpoints

Infect Dis Clin North Am. 2026 Mar;40(1):23-39. doi: 10.1016/j.idc.2025.12.001. Epub 2026 Jan 13.

Abstract

Acinetobacter baumannii, particularly carbapenem-resistant strains (CRAB), represents a critical global health threat due to its multidrug resistance and association with severe healthcare-associated infections. Treatment options remain limited, with high mortality rates observed in ventilator-associated pneumonia (VAP), bloodstream infections (BSI), and central nervous system (CNS) infections. Colistin-based regimens, despite toxicity and pharmacokinetic limitations, have long been standard therapy. Recent therapeutic advances include cefiderocol and sulbactam/durlobactam, which show potential activity, especially when used in combination regimens.

Keywords: A baumannii; CRAB; Cefiderocol; Colistin; Eravacycline; Sulbactam/durlobactam.

Publication types

  • Review

MeSH terms

  • Acinetobacter Infections* / drug therapy
  • Acinetobacter Infections* / microbiology
  • Acinetobacter baumannii* / drug effects
  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • Carbapenems* / pharmacology
  • Carbapenems* / therapeutic use
  • Cefiderocol
  • Colistin / therapeutic use
  • Drug Resistance, Multiple, Bacterial
  • Humans
  • beta-Lactam Resistance*

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Cefiderocol
  • Colistin