New Treatment Options for XDR Acinetobacter
In my mind, multi drug resistant Acinetobacter is the greatest unmet need in antibiotic therapy today. The new β-lactam/β-lactamase inhibitor combinations such as ceftazidime/avibactam and meropenem/vaborbactam do not offer good options against MDR Acinetobacter . Plazomicin, the new aminoglycosides, also does not offer anything as a treatment for Acinetobacter . Here is a brief review of some of the options under development for carbapenem resistant Acinetobacter . Cefiderocol The one new drug close to availability which does have anti- Acinetobacter activity is cefiderocol. Cefiderocol, a siderophore cephalosporin, has been used successfully for UTI but we have no reports yet of its clinical use against Acinetobacter. However, in vitro, it appears to be highly active. In a poster at ID Week 2017, cefiderocol was active against 89% of a set of well characterised strains from the CDC. Not perfect, but certainly an advance on our current armamentarium. It is currently in phase