Sulbactam-Durlobactam, A Novel Drug for the Treatment of Multidrug-resistant Acinetobacter baumannii Infections - A Systematic Review.

BACKGROUND: Sulbactam-durlobactam (SUL-DUR) has been tested in vitro for its ability to gen- erate resistance in clinical isolates of Acinetobacter species. According to prior studies, combining durlobac- tam with sulbactam causes sulbactam-resistant isolates to become more active and revert to susceptibility. We aimed to conduct a systematic review of the in vitro activity of SUL-DUR on A. baumannii (Ab) iso- lates, including carbapenem-resistant A. baumannii (CRAb), to provide an overview for physicians dealing with Ab infections.

METHODS: The following keywords were searched in the PubMed, Google Scholar, and EMBASE databases to look for eligible original works that have been published without restrictions till June 30, 2023: A. bau- mannii and sulbactam-durlobactam, SUL-DUR, durlobactam, and sulbactam-ETX2514. We also searched clinicaltrials.gov and the Clinical Trials Registry of India (CTRI) for clinical trials involving sulbactam- durlobactam and Acinetobacter.

RESULTS: There were a total of 852 abstracts found. Among them, 633 articles with titles, abstracts, and key- words were reviewed, and 574 articles were removed after the initial screening. A total of 59 full-text eligi- ble articles were evaluated, and 51 of them were eliminated because they did not satisfy the criteria set for inclusion. The full texts of the final 8 in vitro studies on A. baumanii and sulbactam/durlobactam were fur- ther evaluated. There were 5 trials on A. baumanii and sulbactam/durlobactam found on clinicaltrials.gov and the Clinical Trial Registry of India (CTRI).

CONCLUSION: The findings from the studies show that SUL-DUR might be a successful therapeutic option for multidrug-resistant-Ab infections. Future clinical trials will be required to validate the possibility of using this combination to treat multidrug-resistant A. baumannii infections.