# Sulbactam–Durlobactam in the Treatment of Bloodstream Infection Due to Carbapenem-Resistant Acinetobacter baumannii: A Case Series and Literature Review

## TL;DR

This paper reports successful treatment of bloodstream infections caused by drug-resistant Acinetobacter baumannii using a new drug combination in critically ill patients.

## Contribution

The study provides real-world evidence of sulbactam–durlobactam's efficacy in treating CRAB bloodstream infections in China.

## Key findings

- Sulbactam–durlobactam improved clinical outcomes in five critically ill patients with CRAB bloodstream infections.
- The drug combination marked a turning point in patient recovery trajectories.
- The findings support re-evaluating current treatment guidelines for CRAB infections.

## Abstract

Background: Carbapenem-resistant Acinetobacter baumannii (CRAB), as a critical-priority pathogen among extensively drug-resistant (XDR) bacteria, influences healthcare-associated infections in China. Sulbactam–durlobactam (SUL-DUR) is recommended as a first-line agent for managing CRAB infections by the 2024 Infectious Diseases Society of America (IDSA) guidelines, but the usage of SUL-DUR for CRAB bloodstream infections (BSIs) has never been described in China. Methods: The present study aims to report five critically ill ICU patients recently treated in our center with CRAB BSIs who were successfully treated with SUL-DUR. Relevant literature and current guidelines are being briefly reviewed to provide a novel and promising clinical paradigm for managing BSI caused by CRAB. Findings: Use of SUL-DUR marked a definitive turning point in all five patients’ clinical trajectories. Conclusions: Our real-world evidence confirms SUL-DUR’s efficacy as a first-line agent for confirmed CRAB BSI cases and the definitive salvage therapy agent, impels a re-evaluation of the current clinical therapeutic spectrum for CRAB infection.