EVIDENCE-BASED ANTIBIOTIC MANAGEMENT OF ACINETOBACTER BAUMANNII MULTIDRUG-RESISTANT INFECTION- A SYSTEMATIC REVIEW

Multidrug-resistant (MDR) Acinetobacter baumannii has emerged as a major global health concern due to its
remarkable ability to survive in hospital environments and develop resistance to multiple antibiotic classes. This
systematic review synthesizes evidence from 2015 to 2025 on the efficacy, safety, and clinical outcomes of various
antibiotic regimens used in managing MDR Acinetobacter baumannii infections. A comprehensive search across
PubMed, ScienceDirect, Scopus, Google Scholar, and the Cochrane Library identified relevant studies, which
were screened and appraised using PRISMA 2020 guidelines. Findings reveal that traditional monotherapies such
as colistin and tigecycline exhibit moderate efficacy and significant toxicity, whereas combination therapies—
particularly colistin with rifampicin or carbapenems—demonstrate higher clinical cure rates and reduced
mortality. The novel siderophore cephalosporin cefiderocol achieved the best outcomes, with clinical cure rates
up to 80% and the lowest mortality (≈22.5%), attributed to its ability to overcome β-lactamase–mediated resistance
mechanisms. Evidence strongly supports the use of combination and novel regimens over monotherapy to enhance
therapeutic success and minimize toxicity. Strengthening antimicrobial stewardship and continuous surveillance
are imperative to combat the growing threat of MDR Acinetobacter baumannii and preserve antibiotic efficacy.