CientouneroComparison of clinical and safety outcomes in patients with #Stenotrophomonasmaltophilia #bacteremia: a #trimethoprimsulfamethoxazole versus levofloxacin monotherapy | Infection
https://link.springer.com/article/10.1007/s15010-025-02695-6
#Levofloxacin appeared to be more effective and safer than TMP/SMX in this retrospective analysis; however, this interpretation should be made with caution given the observational nature of the study. Further randomized clinical trials are warranted to validate these findings
Comparison of clinical and safety outcomes in patients with Stenotrophomonas maltophilia bacteremia: a trimethoprim/sulfamethoxazole versus levofloxacin monotherapy - Infection
Purpose The study aimed to compare the clinical outcomes and safety of trimethoprim/sulfamethoxazole (TMP/SMX) versus levofloxacin monotherapy in patients with monomicrobial Stenotrophomonas maltophilia (S. maltophilia) bacteremia. Methods We conducted a retrospective cohort study of adult inpatients with monomicrobial S. maltophilia bacteremia at a tertiary medical center in Taiwan from January 2004 to June 2025. Patients were divided into two groups for comparison based on antibiotic treatment: TMP/SMX and levofloxacin monotherapy. Primary outcome was 30-day mortality. Secondary outcomes included in-hospital mortality, clinical response, microbiological eradication, non-susceptible strains emergence, recurrent bacteremia, and adverse drug reactions. Multivariable logistic regression and propensity score analysis were performed using inverse probability of treatment weighting (IPTW). Results Among 226 patients, 129 received levofloxacin and 97 received TMP/SMX. The levofloxacin-treated group was associated with lower 30-day mortality (17.8% vs. 36.1%, p = 0.002) in the primary analysis. In the multivariable logistic regression model, levofloxacin use was independently associated with improved outcomes (p = 0.047). Similarly, in the IPTW analysis, levofloxacin use remained a factor of lower 30-day mortality (p = 0.026). Additionally, microbiological eradication, emergence of non-susceptible strains, and recurrent bacteremia were comparable between the treatment groups, while adverse events were significantly less frequent in patients treated with levofloxacin (3.1% vs. 25.8%, p < 0.001). Conclusions Levofloxacin appeared to be more effective and safer than TMP/SMX in this retrospective analysis; however, this interpretation should be made with caution given the observational nature of the study. Further randomized clinical trials are warranted to validate these findings.
News Beep
MrMed : Online Pharmacy
micrordt
Gabriele Pollara
Giuseppe Michieli
Vivek Mutalik
SIDP