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Chapters

Part III: Guidelines for Selected Antimicrobial Use



3.11 Sulbactam-durlobactam



  1. Sulbactam is a β-lactam with intrinsic activity against Acinetobacter baumannii, however, it is hydrolysed by various β-lactamases produced by the bacteria. [254]

  2. Durlobactam is a β-lactamase inhibitor with activity against Ambler class A, C, and D β-lactamases. [254] It does not inhibit class B metallo-β-lactamases, for example, NDM. [256]

  3. Sulbactam-durlobactam demonstrates in vitro activity against A. baumannii, including carbapenem-resistant isolates. [266–268] and the majority of CRAB resistant to colistin and cefiderocol. [269]

  4. Dosing

Adults with creatinine clearance of 45–129 mL/min

Sulbactam-durlobactam (1 g of sulbactam, 1 g of durlobactam) every 6 hours by intravenous infusion over 3 hours [256,270]

Dosing adjustments are recommended for creatinine clearance (CrCl) <45 mL/min or CrCl greater than or equal to 130 mL/min. [270]

  1. Concomitant administration of organic anion transporter 1 (OAT1) inhibitor (e.g. probenecid) is not recommended as co-administration may increase plasma concentrations of sulbactam. [270]

  2. At the time of writing, sulbactam-durlobactam is not available in Hong Kong. Please consult a clinical microbiologist or infectious disease physician regarding the use of sulbactam-durlobactam.



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