Comparison of Doxycycline or Minocycline to Sulfamethoxazole-Trimethoprim for Treatment of Stenotrophomonas maltophilia Pneumonia.

Autor:	Alhayani T; Department of Pharmacy Services, Good Samaritan Hospital, TriHealth, Cincinnati, OH, USA.; Department of Pharmacy Services, University of Cincinnati Medical Center, UC Health, Cincinnati, OH, USA., Philpott CD; Department of Pharmacy Services, University of Cincinnati Medical Center, UC Health, Cincinnati, OH, USA.; James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA., Liao S; Department of Pharmacy Services, University of Cincinnati Medical Center, UC Health, Cincinnati, OH, USA.; James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA., Gentene AJ; Department of Pharmacy Services, University of Cincinnati Medical Center, UC Health, Cincinnati, OH, USA.; James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA., Mueller EW; Department of Pharmacy Services, University of Cincinnati Medical Center, UC Health, Cincinnati, OH, USA.; James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA.
Jazyk:	angličtina
Zdroj:	The Annals of pharmacotherapy [Ann Pharmacother] 2024 Jan; Vol. 58 (1), pp. 21-27. Date of Electronic Publication: 2023 Apr 26.
DOI:	10.1177/10600280231166413
Abstrakt:	Background: Stenotrophomonas maltophilia is a multidrug-resistant organism with limited antibiotic treatment options. Minocycline and doxycycline may be appropriate, but clinical data are limited. Objective: To compare tetracyclines (minocycline and doxycycline [TCN]) with standard of care, sulfamethoxazole-trimethoprim (TMP-SMZ), in S. maltophilia pneumonia treatment. Methods: This retrospective, 2-center study evaluated patients treated for S. maltophilia pneumonia with TCN or TMP-SMZ for clinical success, defined as resolution of leukocytosis, fever, and tachypnea. Patients were classified as treatment with TCN or TMP-SMZ based on definitive agent used for ≥50% of the treatment course and ≥4 days. Inclusion criteria were age ≥18 years, S. maltophilia confirmed on respiratory culture from January 2013 to November 2020, and appropriate definitive antibiotic dosing. Pregnancy, incarceration, S. maltophilia -resistant or intermediate to definitive therapy, and combination therapy for treatment of S. maltophilia pneumonia were exclusion criteria. Secondary outcomes were microbiologic success and recurrence or reinfection within 30 days requiring treatment. Results: A total of 80 patients were included (21 TCN [15 minocycline, 6 doxycycline], 59 TMP-SMZ). There was no difference in clinical success (28.6% vs 25.4%; P = 0.994), microbiologic success (n = 28, 55.6% vs 66.4%; P = 0.677), or recurrence or reinfection (n = 24, 66.7% vs 26.7%; P = 0.092) between TCN and TMP-SMZ, respectively. Conclusion and Relevance: Clinical and microbiologic success rates were similar in patients treated with TCN compared with TMP-SMZ for S. maltophilia pneumonia. These data suggest minocycline and doxycycline may be options to treat S. maltophilia pneumonia, but conclusive clinical data continue to be lacking. Competing Interests: Declaration of Conflicting InterestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Anthony J. Gentene served on a joint advisory board for Theravance Biopharma US, Inc, and Mylan Specialty LP.
Databáze:	MEDLINE
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