Sulbactam–Durlobactam in the Treatment of Bloodstream Infection Due to Carbapenem-Resistant Acinetobacter baumannii: A Case Series and Literature Review

<b>Background:</b> Carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB), as a critical-priority pathogen among extensively drug-resistant (XDR) bacteria, influences healthcare-associated infections in China. Sulbactam-durlobactam (SUL-DUR) is recommended as a first-line agent for managing CRAB infections by the 2024 Infectious Diseases Society of America (IDSA) guidelines, but the usage of SUL-DUR for CRAB bloodstream infections (BSIs) has never been described in China. <b>Methods:</b> The present study aims to report five critically ill ICU patients recently treated in our center with CRAB BSIs who were successfully treated with SUL-DUR. Relevant literature and current guidelines are being briefly reviewed to provide a novel and promising clinical paradigm for managing BSI caused by CRAB. <b>Findings:</b> Use of SUL-DUR marked a definitive turning point in all five patients' clinical trajectories. <b>Conclusions:</b> Our real-world evidence confirms SUL-DUR's efficacy as a first-line agent for confirmed CRAB BSI cases and the definitive salvage therapy agent, impels a re-evaluation of the current clinical therapeutic spectrum for CRAB infection.