New Perspectives on Antimicrobial Agents: Sulbactam-durlobactam

Abstract

Infections due to Carbapenem-resistant Acinetobacter baumannii (CRAB) are a significant burden and are associated with devastating outcomes. Subsequently, CRAB is recognized as an urgent threat to human health by the United States (US) Centers for Disease Control and Prevention and is designated a critical pathogen, with the highest priority for research and development of novel treatment options, by the World Health Organization. Sulbactam-durlobactam was approved by the US Food and Drug Administration in 2023 for the treatment of Hospital Acquired and Ventilator Associated Bacterial Pneumonia caused by susceptible strains of A. baumannii, and as of 2024, is the Infectious Diseases Society of America Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections preferred treatment strategy, in combination with a carbapenem, for infections due to CRAB. In this commentary, we will dive into the preclinical and clinical evidence supporting this approval. We will further explore controversial and emerging questions related to sulbactam-durlobactam, including the necessity of carbapenem combination therapy for CRAB and the other potential therapeutic opportunities durlobactam may provide beyond A. baumannii.