Current and novel therapies for management of Acinetobacter baumannii-associated pneumonia

Abstract

Acinetobacter baumannii is a common pathogen associated with hospital-acquired pneumonia showing increased resistance to carbapenem and colistin antibiotics nowadays. Infections with A. baumannii cause high patient fatalities due to their capability to evade current antimicrobial therapies, emphasizing the urgency of developing viable therapeutics to treat A. baumannii-associated pneumonia. In this review, we explore current and novel therapeutic options for overcoming therapeutic failure when dealing with A. baumannii-associated pneumonia. Among them, antibiotic combination therapy administering several drugs simultaneously or alternately, is one promising approach for optimizing therapeutic success. However, it has been associated with inconsistent and inconclusive therapeutic outcomes across different studies. Therefore, it is critical to undertake additional clinical trials to ascertain the clinical effectiveness of different antibiotic combinations. We also discuss the prospective roles of novel antimicrobial therapies including antimicrobial peptides, bacteriophage-based therapy, repurposed drugs, naturally-occurring compounds, nanoparticle-based therapy, anti-virulence strategies, immunotherapy, photodynamic and sonodynamic therapy, for utilizing them as additional alternative therapy while tackling A. baumannii-associated pneumonia. Importantly, these innovative therapies further require pharmacokinetic and pharmacodynamic evaluation for safety, stability, immunogenicity, toxicity, and tolerability before they can be clinically approved as an alternative rescue therapy for A. baumannii-associated pulmonary infections.

Keywords:

• Acinetobacter baumannii-associated pneumonia
• novel therapies
• hospital-acquired pneumonia
• Acinetobacter baumannii
• current antimicrobial therapies

Authors contributions

The authors contributed equally to all aspects of the article.

Inclusion and diversity

We, the authors of this paper, embrace inclusive, diverse, and equitable conduct of research. Our team comprises individuals who self-identify as underrepresented ethnic minorities, gender minorities, members of the LGBTQIA + community, and individuals living with disabilities. We actively promote gender balance in our reference list while maintaining scientific relevance.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Aye Mya Sithu Shein was supported by Chulalongkorn University (Second Century Fund- C2F Fellowship). Dhammika Leshan Wannigama was supported by Chulalongkorn University (Second Century Fund- C2F Fellowship), the University of Western Australia (Overseas Research Experience Fellowship), and Yamagata Prefectural Central Hospital, Yamagata, Japan (Clinical Residency Fellowship). Anthony Kicic is a Rothwell Family Fellow. Daniel Pletzer and O’Rorke Kevin Smith received support from the Otago Medical Research Foundation (Laurenson Award 2022). The sponsor(s) had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.