Current opinion in infectious diseases · 2025
From clinical trials to daily practice: how to adequately administer sulbactam-durlobactam? alone or combined with imipenem?
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Bonazzetti Cecilia, Giannella Maddalena, Pascale Renato
Аннотация
PURPOSE OF REVIEW: Sulbactam-durlobactam (SUL-DUR) is a novel β-lactam/β-lactamase inhibitor combination recently approved for carbapenem-resistant Acinetobacter baumannii (CRAB) infections. This review summarizes current knowledge on the optimal use of SUL-DUR, whether administered alone or in combination with carbapenems, particularly imipenem.
RECENT FINDINGS: Data from registrational trial demonstrate that SUL-DUR is an effective and well tolerated treatment option for CRAB severe infections. However, this trial assessed the efficacy of SUL-DUR exclusively in combination with imipenem. Real-world reports have described successful use of SUL-DUR in combination with carbapenems and other agents, particularly in complex or drug-resistant cases. Microbiological data suggest synergistic effects between SUL-DUR and carbapenems due to complementary inhibition of different penicillin-binding proteins.
SUMMARY: Combination therapy of SUL-DUR with carbapenems remains the preferred strategy in critically ill or high-risk patients. Future trials should specifically evaluate the comparative efficacy of monotherapy vs. combination regimens and establish which could be the best companion in the treatment of CRAB infections.
RECENT FINDINGS: Data from registrational trial demonstrate that SUL-DUR is an effective and well tolerated treatment option for CRAB severe infections. However, this trial assessed the efficacy of SUL-DUR exclusively in combination with imipenem. Real-world reports have described successful use of SUL-DUR in combination with carbapenems and other agents, particularly in complex or drug-resistant cases. Microbiological data suggest synergistic effects between SUL-DUR and carbapenems due to complementary inhibition of different penicillin-binding proteins.
SUMMARY: Combination therapy of SUL-DUR with carbapenems remains the preferred strategy in critically ill or high-risk patients. Future trials should specifically evaluate the comparative efficacy of monotherapy vs. combination regimens and establish which could be the best companion in the treatment of CRAB infections.