3 years ago

Combating carbapenem-resistant Acinetobacter baumannii by an optimized imipenem plus tobramycin dosage regimen - prospective validation via hollow fiber infection and mathematical modeling.

Cornelia B Landersdorfer, Roger L Nation, Beom Soo Shin, Tae Hwan Kim, Rajbharan Yadav, John D Boyce, Jürgen B Bulitta, Kate E Rogers
We aimed to prospectively validate an optimized combination dosage regimen against a clinical carbapenem-resistant Acinetobacter baumannii (CRAB; MICImipenem: 32mg/liter, MICTobramycin: 2mg/liter). Imipenem at constant concentrations (7.6, 13.4 and 23.3mg/liter, reflecting a range of clearances) was simulated in a 7-day hollow fiber infection model (inoculum ∼107.2 CFU/mL) with and without tobramycin (7mg/kg q24h, 0.5h infusions). While monotherapies achieved no killing or failed by 24h, this rationally optimized combination achieved >5 log10 bacterial killing and suppressed resistance.

Publisher URL: http://doi.org/10.1128/AAC.02053-17

DOI: 10.1128/AAC.02053-17

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