Trimethoprim-sulfamethoxazole versus levofloxacin for the treatment of Stenotrophomonas maltophilia infections: A multicentre cohort study

IF 3.7 3区 医学 Q2 INFECTIOUS DISEASES
Thamer A. Almangour , Zakiyah Alkherb , Shatha Alruwaite , Renad Alsahli , Hussain Alali , Abdullah Almohaizeie , Sara Almuhisen , Shuroug A. Alowais , Khalid Bin Saleh , Lolwa Fetyani , Fai Alnashmi , Alnajla Alghofaily , Noran Ibrahim Abouobaid , Khalifa M. Binkhamis , Essam A. Tawfik , Yazed Saleh Alsowaida
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Abstract

Background

Trimethoprim-sulfamethoxazole (TMP-SMX) has long been considered the treatment of choice for infections caused by Stenotrophomonas maltophilia. Levofloxacin has emerged as a potential option for treating these infections. This study aimed to evaluate the clinical outcomes in patients who received TMP-SMX versus levofloxacin for treating S. maltophilia infections.

Methods

A retrospective, cohort study was conducted in 4 tertiary centres and included patients who were treated with either TMP-SMX or levofloxacin for infections caused by S. maltophilia. The main study outcomes were overall in-hospital mortality, 30-d mortality, and clinical cure. Safety outcomes were also evaluated. Multivariate analysis using logistic regression was used to control for the effect of the covariables.

Results

We included 371 patients in this study, 316 received TMP-SMX and 55 patients received levofloxacin. A total of 70% were in the intensive care unit and 21% presented with bacteraemia. No statistically significant differences were observed in overall in-hospital mortality (52% vs. 40%; P = 0.113; odd ratio [OR], 1.59; 95% confidence interval [CI], 0.89–2.86), 30-d mortality (28% vs. 25%; P = 0.712; OR, 1.13; 95% CI, 0.59–2.18), or clinical cure (55% vs. 64%; P = 0.237; OR, 0.70; 95% CI, 0.37–1.31). Rates of acute kidney injury were comparable between the two groups (11% vs. 7%; P = 0.413).

Conclusion

Patients receiving levofloxacin for the treatment of infections caused by S. maltophilia demonstrated clinical outcomes similar to those receiving TMP-SMX. Our study suggests that levofloxacin can be a reasonable alternative to TMP-SMX to treat these infections.

治疗嗜麦芽单胞菌感染的三甲双胍-磺胺甲恶唑与左氧氟沙星:一项多中心队列研究。
背景:长期以来,三甲氧苄啶-磺胺甲噁唑(TMP-SMX)一直被认为是治疗嗜麦芽霉菌感染的首选药物。左氧氟沙星已成为治疗此类感染的潜在选择。本研究旨在评估接受 TMP-SMX 与左氧氟沙星治疗嗜麦芽单胞菌感染的患者的临床疗效:在 4 个三级医疗中心开展了一项回顾性队列研究,研究对象包括接受 TMP-SMX 或左氧氟沙星治疗的嗜麦芽糖酵母菌感染患者。研究的主要结果是住院总死亡率、30 天死亡率和临床治愈率。此外,还对安全性进行了评估。使用逻辑回归进行多变量分析,以控制协变量的影响:本研究共纳入 371 例患者,其中 316 例接受了 TMP-SMX 治疗,55 例接受了左氧氟沙星治疗。共有 70% 的患者住进了重症监护室,21% 的患者出现菌血症。在院内总死亡率(52% vs 40%;P = 0.113;OR,1.59;95% CI,0.89-2.86)、30 天死亡率(28% vs 25%;P = 0.712;OR,1.13;95% CI,0.59-2.18)或临床治愈率(55% vs 64%;P = 0.237;OR,0.70;95% CI,0.37-1.31)方面,未观察到有统计学意义的差异。两组急性肾损伤发生率相当(11% vs 7%; p = 0.413):结论:接受左氧氟沙星治疗嗜麦芽糖酵母菌感染的患者的临床结果与接受TMP-SMX治疗的患者相似。我们的研究表明,左氧氟沙星是治疗此类感染的TMP-SMX的合理替代品。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of global antimicrobial resistance
Journal of global antimicrobial resistance INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY
CiteScore
8.70
自引率
2.20%
发文量
285
审稿时长
34 weeks
期刊介绍: The Journal of Global Antimicrobial Resistance (JGAR) is a quarterly online journal run by an international Editorial Board that focuses on the global spread of antibiotic-resistant microbes. JGAR is a dedicated journal for all professionals working in research, health care, the environment and animal infection control, aiming to track the resistance threat worldwide and provides a single voice devoted to antimicrobial resistance (AMR). Featuring peer-reviewed and up to date research articles, reviews, short notes and hot topics JGAR covers the key topics related to antibacterial, antiviral, antifungal and antiparasitic resistance.
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