Isolating carbapenem-resistant Acinetobacter Baumannii (CRAB) in a patient may represent colonization or infection; distinguishing between the two is challenging

CRAB isolated from non-sterile sites or from sterile sites that have an indwelling device without signs of infection represents colonization and should not be treated (see Fig. 1)

Current treatment options and clinical data are limited. No agent or combination regimen has been shown to be superior to any other in randomized clinical trials

Ampicillin-sulbactam appears to have the best evidence for initial use. This is probably due to its ability to saturate penicillin-binding proteins 1 and 3 when given in high dose

Combination therapy appears to be the best treatment option and should always include high-dose ampicillin-sulbactam combined with another active agent such as high-dose tigecycline, polymyxins or one of the other newer agents (cefiderocol, eravacycline) (see Table 1)