Manesh A.George M.M.Palanikumar P.Nagaraj V.Bhanuprasad K.Krishnan R.Nivetha G.Lal B.Triveni K.R.Gautam P.George B.Kulkarni U.Mathews V.Subramani K.Rao S.Chacko B.Zachariah A.Sathyendra S.Hansdak S.G.Abraham O.C.Iyadurai R.Karthik R.Peter J.V.Mo Y.Veeraraghavan B.Varghese G.M.Paterson D.L.Mahidol University2024-10-012024-10-012024-01-01Infectious Diseases and Therapy (2024)21938229https://repository.li.mahidol.ac.th/handle/20.500.14594/101435Introduction: International guidelines recommend definitive combination antibiotic therapy for the management of serious infections involving carbapenem-resistant Acinetobacter (CRAB) species. The commonly available combination options include high-dose sulbactam, polymyxins, tetracyclines, and cefiderocol. Scanty prospective data exist to support this approach. Methods: Patients with CRAB bacteraemia, ventilator-associated pneumonia (VAP), or both were categorized based on whether they received combination therapy or monotherapy. The 30-day mortality was compared between the two groups. Inverse probability treatment weighting (IPTW) was done using propensity score (PS) for a balanced comparison between groups. Results: Between January 2021 and May 2023, of the 161 patients with CRAB bacteraemia (n = 55, 34.2%), VAP (n = 46, 28.6%), or both (n = 60, 37.3%) who received appropriate intravenous antibiotic therapy, 70% (112/161) received monotherapy, and the rest received combination therapy. The overall 30-day mortality was 62% (99/161) and not different (p = 0.76) between the combination therapy (31/49, 63.3%) and monotherapy (68/112, 60.7%) groups. The propensity score matching using IPTW did not show a statistical difference (p = 0.47) in 30-day mortality for receiving combination therapy with an adjusted odds ratio (OR) P of 1.29 (0.64, 2.58). Conclusion: Combination therapy for CRAB infections needs further study in a randomised controlled trial, as this observational study showed no difference in 30-day mortality between monotherapy and combination therapy.MedicineArticleSCOPUS10.1007/s40121-024-01042-w2-s2.0-8520480460821936382