Journal
PHARMACOTHERAPY
Volume 43, Issue 6, Pages 502-513Publisher
WILEY
DOI: 10.1002/phar.2802
Keywords
Acinetobacter baumannii; carbapenem-resistant Acinetobacter baumannii (CRAB); phase III ATTACK trial; sulbactam-durlobactam (SUL-DUR); beta-lactam-beta-lactamase inhibitor
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SUL-DUR is a novel beta-lactam-beta-lactamase inhibitor designed for the treatment of carbapenem-resistant Acinetobacter baumannii (CRAB) infections. The FDA's fast-track approval for SUL-DUR is pending after the completion of the phase III ATTACK trial, which showed that SUL-DUR was non-inferior to colistin with a better safety profile. With limited treatment options available, SUL-DUR holds promise for the treatment of CRAB infections.
Carbapenem-resistant Acinetobacter baumannii (CRAB) is a difficult-to-treat nosocomial pathogen responsible for significant morbidity and mortality. Sulbactam-durlobactam (SUL-DUR), formerly ETX2514SUL, is a novel beta-lactam-beta-lactamase inhibitor designed specifically for the treatment of CRAB infections. The United States Food and Drug Administration (FDA) fast-track approval of SUL-DUR for the treatment of CRAB infections is currently pending after completion of the phase III ATTACK trial, which compared SUL-DUR to colistin, both in combination with imipenem-cilastatin (IMI) for patients with CRAB-associated hospital-acquired bacterial pneumonia, ventilator-associated pneumonia, and bacteremia. The results of this trial demonstrated that SUL-DUR was non-inferior to colistin for CRAB while also possessing a much more favorable safety profile. SUL-DUR was well-tolerated with the most common side effects being headache, nausea, and injection-site phlebitis. With the current landscape of limited effective treatment options for CRAB infections, SUL-DUR represents a promising therapeutic option for the treatment of these severe infections. This review will discuss the pharmacology, spectrum of activity, pharmacokinetics/pharmacodynamics, in vitro and clinical studies, safety, dosing, administration, as well as the potential role in therapy for SUL-DUR.
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