Trimethoprim-Sulfamethoxazole or Minocycline for Stenotrophomonas maltophilia Pneumonia?

Clinical cure rates were similar between treatment groups, but in-hospital mortality in the TMP/SMX group was double that in the MINO group.

Stenotrophomonas maltophilia is an increasingly frequent cause of hospital- and ventilator-associated pneumonia (HAP/VAP). Intrinsic resistance of this pathogen to many relevant antibiotics represents a substantial barrier to satisfactory clinical outcomes, with mortality ranging from 20% to 70%. In a retrospective cohort study, researchers assessed clinical cure and adverse effects associated with trimethoprim-sulfamethoxazole (TMP/SMX; n=48) versus minocycline (MINO; n=45) for treatment of patients with S. maltophilia pneumonia.

Although incidence of clinical cure did not differ significantly between groups (73% [TMP/SMX] and 67% [MINO]), all-cause in-hospital mortality was significantly higher in the TMP/SMX group than the MINO group (48%…

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases