鲍曼不动杆菌是与医院获得性肺炎相关的常见病原体,目前对碳青霉烯类和粘菌素抗生素的耐药性增加。鲍曼不动杆菌感染由于其逃避当前抗菌治疗的能力而导致高病死率。强调开发可行的治疗鲍曼不动杆菌相关性肺炎的紧迫性。在这次审查中,我们探讨了当前和新的治疗方案,以克服鲍曼不动杆菌相关肺炎治疗失败.其中,抗生素联合疗法同时或交替施用几种药物,是优化治疗成功的一种有希望的方法。然而,在不同的研究中,它与不一致和不确定的治疗结局相关.因此,进行额外的临床试验以确定不同抗生素组合的临床有效性至关重要。我们还讨论了新型抗菌疗法的前瞻性作用,包括抗菌肽,基于噬菌体的治疗,重新利用的药物,天然存在的化合物,基于纳米粒子的治疗,抗毒力策略,免疫疗法,光动力和声动力疗法,利用它们作为额外的替代疗法,同时解决鲍曼不动杆菌相关肺炎。重要的是,这些创新疗法还需要药代动力学和药效学评估的安全性,稳定性,免疫原性,毒性,在临床上被批准作为鲍曼不动杆菌相关肺部感染的替代抢救疗法之前,它们具有耐受性。
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.