Journal
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
Volume 67, Issue 7, Pages 1607-1615Publisher
OXFORD UNIV PRESS
DOI: 10.1093/jac/dks084
Keywords
multidrug resistance; heteroresistance; combination therapy
Funding
- National Natural Science Foundation of China [81000755]
- Beijing Natural Science Foundation of China [7122167]
- Beijing Science and Technology New Star Program of China [2010B079]
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Colistin is the last resort for treatment of multidrug-resistant Acinetobacter baumannii. Unfortunately, resistance to colistin has been reported all over the world. The highest resistance rate was reported in Asia, followed by Europe. The heteroresistance rate of A. baumannii to colistin is generally higher than the resistance rate. The mechanism of resistance might be loss of lipopolysaccharide or/and the PmrAB two-component system. Pharmacokinetic/pharmacodynamic studies revealed that colistin monotherapy is unable to prevent resistance, and combination therapy might be the best antimicrobial strategy against colistin-resistant A. baumannii. Colistin/rifampicin and colistin/carbapenem are the most studied combinations that showed promising results in vitro, in vivo and in the clinic. New peptides showing good activity against colistin-resistant A. baumannii are also being investigated.
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