Abstract
INTRODUCTION: The rising incidence of carbapenem-resistant Acinetobacter baumannii (CRAB) poses challenges in Intensive Care Unit (ICU) settings. Eravacycline, the first fluorocycline antibiotic introduced globally, is increasingly utilized for CRAB-related infections. This study compares eravacycline with tigecycline for CRAB pneumonia in ICU patients. METHODS: This retrospective study analyzed 65 ICU patients with CRAB pneumonia treated at Henan Provincial People's Hospital from September 2023 to March 2024; the clinical efficacy and adverse reactions of eravacycline and tigecycline as target therapies were compared. RESULTS: Both CRAB pneumonia cohorts exhibited more than 50% co-infection rates, predominantly Aspergillus and Klebsiella pneumoniae. Multiple organ dysfunction syndrome (MODS) incidence was significantly higher in the eravacycline group (45.5% vs 15.5%, P<0.05). Prior to target-drug administration, patients in the eravacycline group showed a longer duration of antibiotic therapy (19.79 ± 9.97 days vs 14.25 ± 7.98 days; P<0.05). Similarly, the median hospital stay was longer in the eravacycline group [27 (19.50, 39.00) days] versus the tigecycline group [19 (14.00, 29.00) days]. After the index culture, the median time to antibiotic initiation was longer in the eravacycline group than in the tigecycline group (6.52 ± 5.03 days vs 4.09 ± 3.14 days; P < 0.05). The 30-day mortality rate was lower in the eravacycline group than in the tigecycline group (15.2% vs 25.0%). Notably, no deaths occurred among eravacycline-treated patients who received infectious disease specialist consultations. Infection symptom resolution and cure rates did not differ significantly between the two groups. CONCLUSION: Eravacycline demonstrated non-inferior efficacy to tigecycline in CRAB pneumonia treatment, with a favorable safety profile. Prompt consultation with infectious disease specialists and timely initiation of eravacycline therapy following the index culture are crucial factors in enhancing clinical outcomes.