Sulbactam-durlobactam: a β-lactam/β-lactamase inhibitor combination targeting Acinetobacter baumannii

Future Microbiol. 2024;19(7):563-576. doi: 10.2217/fmb-2023-0248. Epub 2024 Mar 1.

Abstract

Sulbactam-durlobactam is a pathogen-targeted β-lactam/β-lactamase inhibitor combination that has been approved by the US FDA for the treatment of hospital-acquired and ventilator-associated bacterial pneumonia caused by susceptible isolates of Acinetobacter baumannii-calcoaceticus complex (ABC) in patients 18 years of age and older. Sulbactam is a penicillin derivative with antibacterial activity against Acinetobacter but is prone to hydrolysis by β-lactamases encoded by contemporary isolates. Durlobactam is a diazabicyclooctane β-lactamase inhibitor with activity against Ambler classes A, C and D serine β-lactamases that restores sulbactam activity both in vitro and in vivo against multidrug-resistant ABC. Sulbactam-durlobactam is a promising alternative therapy for the treatment of serious Acinetobacter infections, which can have high rates of mortality.

Keywords: Acinetobacter baumannii; carbapenem resistance; pneumonia; sulbactam–durlobactam; β-lactamase inhibitor.

Plain language summary

Sulbactam–durlobactam: a drug for treating lung infectionsAcinetobacter is a type of bacteria. One type, called CRAB, causes serious infections and can be fatal. CRAB is very hard to treat because most drugs no longer work. Sulbactam–durlobactam (SUL-DUR) is a drug that can kill CRAB. The US FDA approved SUL-DUR in May of 2023 for treating lung infections (pneumonia) caused by CRAB. This article explains how SUL-DUR works. Use of SUL-DUR and other drugs to treat these types of infections are discussed. In conclusion, SUL-DUR is a promising therapy for serious infections caused by CRAB.

Publication types

  • Review

MeSH terms

  • Acinetobacter Infections* / drug therapy
  • Acinetobacter Infections* / microbiology
  • Acinetobacter baumannii* / drug effects
  • Acinetobacter baumannii* / enzymology
  • Animals
  • Anti-Bacterial Agents* / pharmacology
  • Azabicyclo Compounds* / pharmacology
  • Drug Combinations
  • Drug Resistance, Multiple, Bacterial
  • Humans
  • Microbial Sensitivity Tests
  • Sulbactam* / pharmacology
  • beta-Lactamase Inhibitors* / pharmacology
  • beta-Lactamases / genetics
  • beta-Lactamases / metabolism
  • beta-Lactams / pharmacology

Substances

  • Sulbactam
  • beta-Lactamase Inhibitors
  • Azabicyclo Compounds
  • Anti-Bacterial Agents
  • durlobactam
  • beta-Lactamases
  • beta-Lactams
  • Drug Combinations