Current and novel therapies for management of Acinetobacter baumannii-associated pneumonia
Aye Mya Sithu Shein1,2, Parichart Hongsing3,4, O'Rorke Kevin Smith5
1Department of Microbiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Abstract:
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.
Insights
Acinetobacter baumannii pneumonia requires new treatments due to antibiotic resistance. This review explores antibiotic combinations and novel therapies like bacteriophages and peptides to combat this severe infection.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Acinetobacter baumannii is a significant cause of hospital-acquired pneumonia.
- Increasing resistance to carbapenem and colistin necessitates urgent therapeutic development.
- High patient fatality rates underscore the need for effective treatments.
Purpose of the Study:
- To review current and novel therapeutic strategies for Acinetobacter baumannii-associated pneumonia.
- To evaluate the potential of antibiotic combination therapy.
- To explore emerging therapies like antimicrobial peptides and bacteriophage therapy.
Main Methods:
- Literature review of current and novel therapeutic options.
- Analysis of antibiotic combination therapy outcomes.
- Discussion of emerging antimicrobial strategies.
Main Results:
- Antibiotic combination therapy shows promise but requires further clinical trials for conclusive outcomes.
- Novel therapies including peptides, phages, and nanoparticles offer potential alternatives.
- Repurposed drugs, anti-virulence strategies, and physical therapies are also discussed.
Conclusions:
- Effective treatment of Acinetobacter baumannii pneumonia is challenged by antimicrobial resistance.
- Combination therapy needs further clinical validation.
- Novel therapeutic approaches require rigorous evaluation for safety and efficacy before clinical approval.
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