Why Sulbactam-Durlobactam Is Now the Priority for Invasive CRAB Infections

Body:The 2026 guidance makes sulbactam-durlobactam, given with a carbapenem, the priority for invasive CRAB infections, with alternative regimens reserved as bridge therapy until the drug is available. The panel also added the term “invasive infections” throughout the section to make clear its suggestions apply to infection and not colonization.“No matter how high…the sulbactam, you probably could not get the job done with sulbactam on its own, even at these higher doses,” said Emily L. Heil, PharmD, MS, FIDP, BCIDP, AAHIVP, professor in the Department of Practice, Sciences, and Health Outcomes Research at the University of Maryland School of Pharmacy and pharmacy director of the Antimicrobial Stewardship Program at the University of Maryland Medical Center, on OXA-23–producing isolates.

In this episode, Heil and Pranita D. Tamma, MD, MHS, of the Department of Pediatrics at the University of Pennsylvania School of Medicine, twalk through the ATTACK trial data, the role of OXA-23 in limiting high-dose sulbactam, and why waiting on susceptibility results should not delay therapy in critically ill patients.