| Autor: |
Shah, Megan D, Coe, Kelci E, Boghdadly, Zeinab El, Wardlow, Lynn C, Dela-Pena, Jennifer C, Stevenson, Kurt B, Reed, Erica E, El Boghdadly, Zeinab |
| Předmět: |
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| Zdroj: |
Journal of Antimicrobial Chemotherapy (JAC); Jul2019, Vol. 74 Issue 7, p2055-2059, 5p |
| Abstrakt: |
Background: Stenotrophomonas maltophilia is intrinsically resistant to several antibiotics, making it potentially challenging to treat. Studies have demonstrated treatment failures and resistance development with monotherapy (MT); however, clinical data are limited with combination therapy (CT).Objectives: To compare clinical outcomes with CT versus MT for S. maltophilia pneumonia.Methods: This was a retrospective cohort study of patients admitted between November 2011 and October 2017 with S. maltophilia pneumonia who received at least 48 h of effective therapy. The primary outcome was clinical response after 7 days of effective therapy with CT versus MT. Secondary outcomes included development of a non-susceptible isolate, 30 day microbiological cure, infection recurrence, infection-related mortality and all-cause mortality. The Wilcoxon rank sum test, the Pearson χ2 test and Fisher's exact test were utilized for univariate analyses. A multivariable logistic regression model was used to assess clinical response while adjusting for confounding variables.Results: Of 252 patients with S. maltophilia pneumonia included, 38 received CT and 214 received MT. There was no difference in 7 day clinical response with CT versus MT (47.4% versus 39.7%, P = 0.38), even after controlling for immune status, APACHE II score and polymicrobial pneumonia (adjusted OR 1.51, 95% CI 0.63-3.65). Thirty day microbiological cure (P = 0.44), recurrence (P = 0.53), infection-related mortality (P = 0.19) and isolation of a non-susceptible isolate during or after therapy (P = 1.00 each) were also similar between both groups; however, 30 day all-cause mortality was greater with CT (P = 0.03).Conclusions: CT had similar rates of clinical efficacy and resistance development compared with MT for S. maltophilia pneumonia. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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