{
  "abstract": "ObjectiveCarbapenem-resistant Acinetobacter baumannii (CRAB) infections present a significant public health challenge in the United States due to multidrug resistance, substantial added inpatient costs, and subsequently high mortality rates.\n\nMethodA decision-analytic model was developed to evaluate the cost-effectiveness of sulbactam-durlobactam compared to colistin for treating CRAB infections, using data from the Acinetobacter Treatment Trial Against Colistin (ATTACK) trial, in which patients received either sulbactam-durlobactam or colistin alongside imipenem-cilastatin. The model incorporated survival rates, clinical outcomes (complete or incomplete cure), and the incidence and costs of acute kidney injury, which is more frequent in colistin-treated patients. Deterministic sensitivity analysis and two scenario analyses were performed.\n\nResultsThe base case analysis estimated an expected per-patient cost of $57,887 for sulbactam-durlobactam compared to $55,157 for colistin. Patients treated with sulbactam-durlobactam had higher survival than those treated with colistin (0.66 versus 0.46), corresponding to 0.19 additional life saved per patient. The incremental cost-effectiveness ratio (ICER) for sulbactam-durlobactam compared with colistin was $14,097 per additional life saved. The ICER was most sensitive to the proportion of survivors with incomplete clinical cure for both treatments, the costs of sulbactam-durlobactam and cefiderocol, and survival outcomes in patients treated with sulbactam-durlobactam. Scenario analyses showed that the cost-effectiveness of sulbactam-durlobactam was sensitive to clinical cure outcomes, with ICERs ranging from $69,758 per additional life saved to dominance favoring sulbactam-durlobactam under different assumptions.\n\nConclusionsAlthough treatment costs were higher, sulbactam-durlobactam has a favorable cost-effectiveness profile as compared with colistin when accounting for the costs of managing acute kidney injury.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pharmacy Practice and Clinical Research, College of Pharmacy, University of Rhode Island, Kingston, 02881, RI, USA"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "A. Ologunowa"
    },
    {
      "name": "A. Caffrey"
    },
    {
      "name": "S. Cohen"
    },
    {
      "name": "S. Kogut"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9t4210801j68d.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.13.26362951",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.09.13.26362951v1.full",
  "id": "9t4210801j68d",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.09.13.26362951v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "infectious diseases"
    ],
    [
      "openalex",
      "1313|Antibiotic Resistance in Bacteria"
    ]
  ],
  "openalex": "W7213542643",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.09.13.26362951v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-13",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/9t4210801j68d.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:49Z",
      "native_id": "10.64898/2026.09.13.26362951",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.09.13.26362951v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:infectious diseases",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Cost-Effectiveness of Sulbactam-durlobactam Compared with Colistin for Treating Carbapenem-Resistant Acinetobacter baumannii Infections in Critical Care Settings in the United States",
  "title_text": "Cost-Effectiveness of Sulbactam-durlobactam Compared with Colistin for Treating Carbapenem-Resistant Acinetobacter baumannii Infections in Critical Care Settings in the United States",
  "type": "preprint",
  "updated_at": "2026-10-30T12:18:49Z",
  "url": "https://research.draconitic.com/paper/9t4210801j68d",
  "venue": "medRxiv",
  "versions": []
}