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Monotherapy versus combination for the treatment of Stenotrophomonas maltophilia: a multicenter cohort study

Thamer A Almangour1, Hussain A Alali2, Zakiyah Alkherb2

  • 1Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.

Expert Review of Anti-Infective Therapy
|May 13, 2024
PubMed
Abstract

Insights

This study found no significant difference in clinical outcomes between monotherapy and combination therapy for *S. maltophilia* infections. However, monotherapy was associated with lower 30-day mortality and acute kidney injury rates.

Area of Science:

  • Infectious Diseases
  • Clinical Pharmacology
  • Medical Microbiology

Background:

  • *Stenotrophomonas maltophilia* is an opportunistic pathogen causing various infections.
  • Treatment strategies include monotherapy and combination therapy.
  • Comparative effectiveness of these strategies requires further investigation.

Purpose of the Study:

  • To compare the safety and effectiveness of monotherapy versus combination therapy for *S. maltophilia* infections.
  • To evaluate clinical cure, mortality rates, and safety outcomes.
  • To identify optimal treatment approaches for *S. maltophilia*.

Main Methods:

  • Retrospective, multicenter, cohort study design.
  • Inclusion of 407 patients treated with monotherapy or combination therapy.
  • Multivariable logistic regression analysis to control for confounding variables.

Main Results:

  • No statistically significant differences in clinical cure or overall in-hospital mortality between monotherapy and combination therapy groups.
  • Monotherapy group showed a lower rate of 30-day mortality (28% vs 32%).
  • Monotherapy group exhibited a significantly lower incidence of acute kidney injury (9% vs 18%).

Conclusions:

  • Clinical outcomes were comparable between monotherapy and combination therapy for *S. maltophilia* infections.
  • Monotherapy may be associated with improved safety outcomes, specifically reduced 30-day mortality and acute kidney injury.
  • Further research is warranted to validate these findings and guide clinical practice.
Keywords:
Stenotrophomonas maltophiliacohort studycombination therapymonotherapytreatment

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