Development of Modernized Acinetobacter baumannii Susceptibility Test Interpretive Criteria for Recommended Antimicrobial Agents Using Pharmacometric Approaches
Alexander J. Lepak, Michael Trang, Jeffrey Hammel, Hélio S. Sader, Sujata M. Bhavnani, Brian VanScoy, Jason M. Pogue, Paul G. Ambrose, David R. Andes
Abstract
Acinetobacter baumannii- Acinetobacter calcoaceticus complex (referred to herein as A. baumannii ) treatment guidelines contain numerous older antimicrobial agents with susceptibility test interpretive criteria (STIC, also known as susceptibility breakpoints) set using only epidemiological data. We utilized a combination of in vitro surveillance data, preclinical murine thigh and lung infection models, population pharmacokinetics, simulation, and pharmacokinetic/pharmacodynamic (PK/PD) target attainment analyses to evaluate A. baumannii STIC for four commonly recommended antimicrobials from different classes (amikacin, ceftazidime, ciprofloxacin, and minocycline).