Current and novel therapies for management of Acinetobacter baumannii -associated pneumonia.
Aye Mya Sithu SheinParichart HongsingO'Rorke Kevin SmithPhatthranit PhattharapornjaroenKazuhiko MiyanagaLongzhu CuiHitoshi IshikawaMohan AmarasiriPeter N MonkAnthony KicicTanittha ChatsuwanDaniel PletzerPaul G HigginsShuichi AbeDhammika Leshan WannigamaPublished in: Critical reviews in microbiology (2024)
Acinetobacter baumannii is a common pathogen associated with hospital-acquired pneumonia showing increased resistance to carbapenem and colistin antibiotics nowadays. Infections with A. baumannii cause high patient fatalities due to their capability to evade current antimicrobial therapies, emphasizing the urgency of developing viable therapeutics to treat A. baumannii -associated pneumonia. In this review, we explore current and novel therapeutic options for overcoming therapeutic failure when dealing with A. baumannii -associated pneumonia. Among them, antibiotic combination therapy administering several drugs simultaneously or alternately, is one promising approach for optimizing therapeutic success. However, it has been associated with inconsistent and inconclusive therapeutic outcomes across different studies. Therefore, it is critical to undertake additional clinical trials to ascertain the clinical effectiveness of different antibiotic combinations. We also discuss the prospective roles of novel antimicrobial therapies including antimicrobial peptides, bacteriophage-based therapy, repurposed drugs, naturally-occurring compounds, nanoparticle-based therapy, anti-virulence strategies, immunotherapy, photodynamic and sonodynamic therapy, for utilizing them as additional alternative therapy while tackling A. baumannii -associated pneumonia. Importantly, these innovative therapies further require pharmacokinetic and pharmacodynamic evaluation for safety, stability, immunogenicity, toxicity, and tolerability before they can be clinically approved as an alternative rescue therapy for A. baumannii -associated pulmonary infections.
Keyphrases
- acinetobacter baumannii
- pseudomonas aeruginosa
- multidrug resistant
- drug resistant
- combination therapy
- clinical trial
- staphylococcus aureus
- gram negative
- respiratory failure
- biofilm formation
- community acquired pneumonia
- cystic fibrosis
- pulmonary hypertension
- randomized controlled trial
- escherichia coli
- oxidative stress
- stem cells
- emergency department
- klebsiella pneumoniae
- small molecule
- mesenchymal stem cells
- adipose tissue
- bone marrow
- type diabetes
- open label
- weight loss
- cell therapy
- antimicrobial resistance
- case report
- insulin resistance
- acute respiratory distress syndrome
- adverse drug
- glycemic control
- mechanical ventilation