Individualized Antimicrobial Therapy using Antibiotic Combination Testing and Therapeutic Drug Monitoring to Treat Carbapenem-Resistant Acinetobacter baumannii Infection

Treatment of multidrug resistant infections is challenging due to limited therapeutic options. To maximise treatment success of such infections, our infectious disease-trained pharmacists employ a two-pronged approach, using both in vitro antibiotic combination testing and therapeutic drug monitoring, to individualise antibiotic combination regimens for our patients, akin to precision medicine. This approach ensures that the most optimal antibiotic combination and dosing regimens are prescribed for our patients with multidrug resistant infection, to ensure adequate antibiotic exposure and maximal clinical efficacy. We describe the implementation of such 2-pronged approach in two of our patients infected with extensively drug-resistant Acinetobacter baumannii infections. Doses higher than manufacturer-approved regimens were administered. Both cases achieved treatment success with no adverse effects.