Sulbactam/avibactam as an alternative strategy for XDR Acinetobacter baumannii ventilator-associated pneumonia: a case report

Abstract

Carbapenem-resistant Acinetobacter baumannii (CRAB) is a critical global threat, particularly in Latin America and Argentina, where carbapenem resistance exceeds 85%. Treatment options are limited and controversial. This article presents a successful case of a patient with ventilator-associated pneumonia caused by extensively drug-resistant (XDR) CRAB, successfully treated with a combination of ampicillin/sulbactam (AMS) and ceftazidime/avibactam (CAZ/AVI). The CRAB isolate was resistant to multiple antibiotics. In vitro testing confirmed that avibactam restored the strain’s susceptibility to sulbactam, demonstrating crucial synergy in regions without access to newer drugs. This case highlights the potential of combining AMS and CAZ/AVI as a viable therapeutic strategy for severe CRAB infections, especially XDR strains, offering a valuable alternative where options are limited.