Successful Treatment with Sulbactam-Durlobactam for Severe Acute Pancreatitis Complicated by Extensively Drug-Resistant Acinetobacter baumannii Infection at Multiple Sites: A Case Report

Zhengmao Ge, Li Li, Longxin Wang, Dengke Liu, Yupeng Liu Department of Critical Care Medicine, The 967 Hospital, Joint Logistics Support Force of PLA, Dalian, 116021, People’s Republic of ChinaCorrespondence: Yupeng Liu, Department of Critical Care Medicine, The 967 Hospital, Joint Logistics Support Force of PLA, No. 80 Shengli Road, Dalian, Liaoning, 116021, People’s Republic of China, Email dalianicu@foxmail.comBackground: The management of severe acute pancreatitis (SAP) complicated by multi-site infections with extensively drug-resistant Acinetobacter baumannii (XDR-AB) represents a critical therapeutic challenge. This report describes, to our knowledge, an early successful application of sulbactam-durlobactam in an SAP patient with concurrent XDR-AB infections in the abdomen, biliary tract and lungs.Case Presentation: A 36-year-old female with hypertriglyceridemic SAP developed infections at multiple sites, with cultures consistently yielding XDR-AB. After the failure of multiple last-line antimicrobial regimens, therapy was switched to sulbactam-durlobactam combined with meropenem. This change was followed by a substantial clinical improvement: body temperature normalized, infection biomarkers decreased significantly and microbiological clearance of XDR-AB from all sites was achieved, leading to successful liberation from mechanical ventilation and discharge from the ICU.Conclusion: This case demonstrates that sulbactam-durlobactam can be a highly effective therapeutic option for achieving both clinical and microbiological cure in complex SAP cases with multi-site XDR-AB infections that are refractory to conventional treatment regimens. It contributes early real-world evidence supporting a new therapeutic strategy for managing such life-threatening, complex infections.Keywords: severe acute pancreatitis, Acinetobacter baumannii, drug resistance, sulbactam-durlobactam, case report