Introduction: Unnecessary or overtreatment treatment of common infections and a lack of interest in the development of new antimicrobials are in part responsible for the increasing number of multi-drug resistant microorganisms. One such pervasive pathogen, Acinetobacter baumanni was once treated commonly with carbapenems. Since 1991, A. baumanni has rapidly evolved resistance to these drugs and other pharmaceuticals at an alarming rate.

Methods: A comprehensive English and non-English search of all articles pertinent to Acinetobacter baumanni infections was conducted using PubMed, a search engine provided by the U.S. National Library of Medicine and the National Institutes of Health. Keywords searched included: ‘multi-drug resistance’, ‘acinetobacter’, ‘nosocomial’, ‘pneumonia, ‘peritonitis’, ‘treatment’ and ‘skin infection’.

Results: Risk factors for various infections caused by A. baumannii including nosocomial pneumonia, peritonitis, and bacteremia were identified. These risks include deficiencies in the implementation of infection control guidelines, prolonged hospital or intensive care unit stay, prolonged or repeated intubation, head injury, acute respiratory distress syndrome, aspiration, previous antibiotic therapy with imipenem, and exposure to fluoroquinolones. A variety of algorithms have been developed for the treatment and eradication of Acinetobacter baumanni infection. These algorithms are not universally applicable, but institutionally dependent on antibiotic sensitivity.

Conclusion: Acinetobacter infections, along with the other organisms associated with the collateral damage of excessive antibiotic usage, are an emerging problem. Such infections should be heeded as harbingers of the developing problems stemming from inadequate enforcement of infection control guidelines, injudicious use of antimicrobials, and the lack of development of new antibiotics. Possible solutions for these problems include the implementation of antibiotic stewardship programs, development of public policy that will foster an environment productive of greater rewards for the development of novel antibiotics and strict enforcement of universal precautions for infection control.