What medications are used in the treatment of Acinetobacter?

Updated: Mar 02, 2021
  • Author: Shirin A Mazumder, MD, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Medications to which Acinetobacter is usually sensitive include the following [5, 9, 10, 11, 12] :

  • Meropenem

  • Colistin

  • Polymyxin B

  • Amikacin

  • Rifampin

  • Minocycline

  • Tigecycline

In general, first-, second-, and third-generation cephalosporins, macrolides, and penicillins have little or no anti-Acinetobacter activity, and their use may predispose to Acinetobacter colonization. Some strains are sensitive to cefepime, ceftazidime, and sulbactam-containing beta-lactam/beta-lactamase–inhibitor drugs.

Monotherapy and combination therapy has been used successfully (eg, amikacin, minocycline, or colistin ± rifampin). Combination therapy is often discussed and suggested, but data proving lower failure rates or lower rates for the development of resistance are inconclusive.

Combination therapy can be considered for empiric therapy when the local rates of antimicrobial resistance to certain antibiotics are high or when the isolate is resistant to several classes of antibiotics. 


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