Journal of Antimicrobial Chemotherapy最新文献

{"title":"Defective HIV-1 DNA pol sequences are not associated with HIV-1 DNA levels and drive most APOBEC-context drug resistance mutations.","authors":"Enagnon Kazali Alidjinou, Pauline Coulon, Macha Tetart, Aurélie Guigon, Ava Diarra, Emmanuelle Aissi, Hélène Bazus, Vincent Derdour, Agnès Meybeck, Nathalie Viget, Didier Hober, Laurence Bocket, Olivier Robineau","doi":"10.1093/jac/dkaf016","DOIUrl":"10.1093/jac/dkaf016","url":null,"abstract":"<p><strong>Introduction: </strong>The specificity of HIV-1 DNA genotypic resistance tests (GRTs) is hampered by the detection of the APOBEC-context drug resistance mutations (AC DRMs), usually harboured by replication-incompetent proviruses. We sought factors associated with defective sequences in the HIV-1 pol region. In addition, AC DRMs and their link with defective sequences were investigated.</p><p><strong>Methods: </strong>We included ART-treated patients with viral suppression or plasma viral load (VL) lower than 200 copies/mL, who underwent HIV-1 DNA genotyping, with successful sequencing of protease (PR), reverse transcriptase (RT) and integrase (IN) regions. Sequencing was performed using either the Sanger method or the Sentosa® NGS approach with a 20% cut-off. All hypermutated sequences and/or those containing at least one stop codon were considered defective.</p><p><strong>Results: </strong>A total of 613 HIV-1 DNA GRTs were analysed. Defective sequences were identified for 186 samples (30.3%) including 65 PR sequences, 92 RT sequences and 65 IN sequences. No association, including HIV-1 DNA levels, was found with the detection of defective pol sequences. A total of 226 AC DRMs were recorded in all sequences. Most of these mutations (78%) were harboured by defective sequences. AC DRMs did not emerge in the plasma viral population, and likely do not impact the virological response to ART.</p><p><strong>Conclusions: </strong>Defectives pol sequences were not associated with HIV-1 DNA levels and harboured most of the AC DRMs. Such mutations likely have no clinical impact, and should not be reported in routine practice. Consensus guidelines for reporting HIV-1 DNA GRTs are needed, especially for the assessment and management of AC DRMs.</p>","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"941-946"},"PeriodicalIF":3.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreased susceptibility to cefepime/zidebactam among carbapenemase-producing Escherichia coli from Stockholm, Sweden with alterations in PBP2.","authors":"Chaitanya Tellapragada, Chantel Dunleavy, Patrik Jonsson, Christian G Giske","doi":"10.1093/jac/dkaf045","DOIUrl":"10.1093/jac/dkaf045","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to investigate the in vitro activity and genetic determinants of decreased susceptibility (DS; MIC > 4 mg/L) to cefepime/zidebactam of carbapenemase-producing Escherichia coli.</p><p><strong>Methods: </strong>Clinical isolates (N = 150) of carbapenemase-producing E. coli (CP-EC) belonging to seven distinct STs, isolated at a university clinical microbiology laboratory during 2019-2023 in Stockholm, Sweden were included. MICs for cefepime/zidebactam were determined using the broth microdilution method and interpreted using the tentative EUCAST clinical breakpoints (Susceptible; MIC < 4 mg/L; based on cefepime breakpoint). Whole genome sequences of the isolates were analysed with an emphasis on identifying alterations in PBPs 2 and 3.</p><p><strong>Results: </strong>Of the 150 isolates, 145 (96.6%) isolates had MICs <4 mg/L indicating susceptibility and 5 (3.3%) had MICs >4 mg/L. MICs for zidebactam alone among the five isolates with DS to cefepime/zidebactam were ≥8 mg/L. WGS analysis revealed that these five isolates were NDM-5 producers and belonged to ST405 (n = 1), ST410 (n = 2) and ST648 (n = 2). Presence of four-amino-acid inserts (YRIK/YRIN) in PBP3 was observed in 80/150 (53.3%) isolates, and mutations leading to alterations in PBP2 were observed in 41/150 (27.3%) isolates. Presence of other β-lactamases (CTX-M group) and/or cephalosporinases (blaCMY) did not have an impact on the susceptibility to cefepime/zidebactam. Three of the five isolates with DS had a V522I substitution in PBP2.</p><p><strong>Conclusions: </strong>Our results indicate that DS to cefepime/zidebactam among clinical isolates of E. coli could arise due to targeted mutations in PBP2.</p>","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"1137-1140"},"PeriodicalIF":3.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highly adsorptive removal of cefiderocol during continuous venovenous hemodiafiltration equipped with oXiris filter in an orthotopic liver transplant recipient having septic shock caused by VIM-producing Klebsiella pneumoniae.","authors":"Milo Gatti, Matteo Rinaldi, Cristiana Laici, Antonio Siniscalchi, Simone Ambretti, Maddalena Giannella, Pierluigi Viale, Federico Pea","doi":"10.1093/jac/dkaf040","DOIUrl":"10.1093/jac/dkaf040","url":null,"abstract":"","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"1153-1155"},"PeriodicalIF":3.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The pharmacodynamics of fosfomycin in combination with meropenem against Klebsiella pneumoniae studied in an in vitro model of infection.","authors":"Alasdair P MacGowan, Pippa Griffin, Marie L G Attwood, Aimee M Daum, Matthew B Avison, Alan R Noel","doi":"10.1093/jac/dkaf020","DOIUrl":"10.1093/jac/dkaf020","url":null,"abstract":"<p><strong>Background: </strong>Intravenous fosfomycin is used in combination with other antimicrobials for the management of severe and/or multidrug resistant Gram-negative infection. We used an in vitro pharmacokinetic model to study the combination of fosfomycin plus meropenem.</p><p><strong>Methods: </strong>Six Klebsiella pneumoniae fosfomycin MICs 8-1024 mg/L, meropenem MICs 0.06->1024 mg/L were employed. A dilutional pharmacokinetic model was used to generate fosfomycin exposure ranges up to a fAUC/MIC 500. Exposure-ranging experiments were repeated in the presence of meropenem at exposures associated with 2 g 8-hourly human dosing for strains with meropenem MICs ≥32 mg/L and at half the bacteriostatic fT > MIC for strains with MICs <32 mg/L. The log change in bacterial burden from the initial inoculum after 24 h drug exposure was taken as the primary endpoint and fAUC/MIC ratios for antibacterial effects were calculated. The risk of emergence of resistance was assessed by measurement of the population profiles.</p><p><strong>Results: </strong>Fosfomycin fAUC/MIC for bacteriostatic effect at 24 h were >500 for 5/6 K. pneumoniae strains. Meropenem fT > MIC for static effect were 16.6%-77.9% for the strains with meropenem MIC ≤ 64 mg/L. Strains with MICs of >1024 mg/L were not tested. Fosfomycin fAUC/MICs in the presence of meropenem were all reduced and for 5/6 strains the fAUC/MIC for static effect was <10 and <30 for a 2 log drop. Addition of meropenem suppressed changes in fosfomycin population profiles. There were no changes in meropenem population profiles exposed to the combination.</p><p><strong>Conclusion: </strong>Addition of meropenem to fosfomycin had a dramatic impact on the fosfomycin fAUC/MIC exposures required for bacteriostatic and bactericidal effects and suppressed emergence of fosfomycin resistance.</p>","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"967-975"},"PeriodicalIF":3.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance evaluation of a fully automated deep sequencing platform for hepatitis B genotyping and resistance testing.","authors":"Valérie Ortonne, Magali Bouvier-Alias, Erwan Vo-Quang, Pierre Cappy, Patrick Ingiliz, Vincent Leroy, Jean-Michel Pawlotsky, Stéphane Chevaliez","doi":"10.1093/jac/dkae418","DOIUrl":"10.1093/jac/dkae418","url":null,"abstract":"<p><strong>Background: </strong>Treatment of chronic hepatitis B infection requires lifelong administration of nucleos(t)ide analogues with a high barrier to resistance and effective viral suppression. The major limitation of lifelong therapy is the possible selection of drug-resistant hepatitis B virus (HBV) strains. International Liver Society guidelines recommend that hepatitis B resistance testing must be performed by a reference laboratory.</p><p><strong>Objectives: </strong>Performance of the deep sequencing-based ViroKey® SQ FLEX Genotyping Assay for the determination of HBV genotypes and resistance profiles were evaluated.</p><p><strong>Patients and methods: </strong>Plasma samples collected from patients with chronic hepatitis B have been sequenced by two methods including Sanger (population) sequencing of a portion of the P/S overlapping gene and the deep sequencing-based ViroKey® SQ FLEX Genotyping Assay (Vela Diagnostics).</p><p><strong>Results: </strong>A high concordance rate with population sequencing was found regardless of HBV genotypes. Deep sequencing with the Sentosa platform was more sensitive than population sequencing in detecting minor variant populations.</p><p><strong>Conclusions: </strong>The deep sequencing-based ViroKey® SQ FLEX Genotyping Assay can be confidently used in clinical practice for hepatitis B genotyping and resistance testing.</p>","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"919-926"},"PeriodicalIF":3.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulated exposures of oritavancin in in vitro pharmacodynamic models select for methicillin-resistant Staphylococcus aureus with reduced susceptibility to oritavancin but minimal cross-resistance or seesaw effect with other antimicrobials.","authors":"Brian J Werth, Rutan Zhang, Ismael A Barreras Beltran, Kelsi Penewit, Adam Waalkes, Elizabeth A Holmes, Stephen J Salipante, Libin Xu","doi":"10.1093/jac/dkaf042","DOIUrl":"10.1093/jac/dkaf042","url":null,"abstract":"<p><strong>Background: </strong>Dalbavancin exposures select for VAN and daptomycin cross-resistance in Staphylococcus aureus often by walK-related mutations. Oritavancin is another long-acting lipoglycopeptide, but its proclivity to select for cross-resistance is unknown. The objective of this study was to determine if post-distributional pharmacokinetic oritavancin exposures select for meaningful susceptibility changes in S. aureus.</p><p><strong>Methods: </strong>We simulated average post-distributional, free-drug exposures of oritavancin 1200 mg IV once (fCmax 11.2 µg/mL; β-elimination t1/2 13.4 h; γ-elimination t1/2 245 h) in an in vitro pharmacodynamic model for 28 days against five S. aureus including four MRSA. Samples were taken daily for colony enumeration and resistance screening. Susceptibility testing was repeated on isolates from resistance screening plates against oritavancin, vancomycin, daptomycin, dalbavancin and 6 beta-lactams with varying penicillin-binding protein affinities.</p><p><strong>Results: </strong>Tested oritavancin exposures were bactericidal against 5/5 strains for 2-17 days before regrowth of less-susceptible subpopulations occurred. Isolates with reduced susceptibility to oritavancin were detected as early as 5 days, but the MIC increased above the susceptibility breakpoint (>0.125 mg/L) in 4/5 strains eventually. Vancomycin and daptomycin MICs increased by 2- to 8-fold but did not exceed the susceptibility breakpoints in most isolates. β-lactam MICs were largely unchanged among the recovered isolates with reduced oritavancin susceptibility. Mutations were diverse but often involved purR with 13 unique variants identified among 4/5 strains.</p><p><strong>Conclusions: </strong>Oritavancin-selected resistance was primarily associated with purR mutation and less frequently associated with cross-resistance and walK mutation than dalbavancin-selected resistance in similar strains and conditions. The reason for this is unclear but may stem from differences in the mechanism(s) and divergent mutational pathways.</p>","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"1108-1115"},"PeriodicalIF":3.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Effect of empiric antibiotics against Pseudomonas aeruginosa on mortality in hospitalized patients: a systematic review and meta-analysis.","authors":"Shubham Kumar, Ahmad Neyazi, Rachana Mehta, Ranjana Sah","doi":"10.1093/jac/dkaf046","DOIUrl":"10.1093/jac/dkaf046","url":null,"abstract":"","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"1161-1162"},"PeriodicalIF":3.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung toxicity related to trimethoprim/sulfamethoxazole: pharmacovigilance data review.","authors":"F Givry, F Lebargy, D Lebrun, M Bonnet, A L Ruellan, M Hentzien, B Azzouz, F Bani-Sadr","doi":"10.1093/jac/dkaf050","DOIUrl":"10.1093/jac/dkaf050","url":null,"abstract":"<p><strong>Background: </strong>Well-established side effects of trimethoprim/sulfamethoxazole include cutaneous and liver toxicity, hypersensitivity syndrome and blood dyscrasias. Trimethoprim/sulfamethoxazole has also been associated with severe lung toxicity (LT) but reports are scarce.</p><p><strong>Methods: </strong>We investigated pharmacovigilance data and reviewed spontaneous reports of trimethoprim/sulfamethoxazole-related LT recorded in the French national pharmacovigilance database (FPVD) and the WHO global database of adverse events (VigiBase®) up to 31 December 2023. We performed disproportionality analysis to detect a possible pharmacovigilance signal.</p><p><strong>Results: </strong>A total of 755 patients with trimethoprim/sulfamethoxazole-related LT were reported in VigiBase®, 17 of which were from the FPVD. In VigiBase®, interstitial lung disease was the most frequent LT pattern (30.5%). A fatal outcome was reported in 197 patients (26.1%). Significant reporting ORs were observed for the following trimethoprim/sulfamethoxazole-related LT patterns: interstitial lung disease 1.5 (95% CI: 1.3-1.7); acute respiratory distress syndrome 2.9 (95% CI: 2.5-3.5); eosinophilic pneumonia 4.1 (95% CI: 3.2-5.2); diffuse alveolar damage 3.7 (95% CI: 2.6-5.3); organizing pneumonia 2.1 (95% CI: 1.4-3.1); pulmonary toxicity 1.9 (95% CI: 1.3-2.9); acute lung injury 7.5 (95% CI: 4.9-11.6) and hypersensitivity pneumonitis 2.7 (95% CI: 1.7-4.2).</p><p><strong>Conclusions: </strong>We highlight statistically significant disproportionality for several trimethoprim/sulfamethoxazole-related LT patterns, which constitutes a pharmacovigilance signal. Trimethoprim/sulfamethoxazole-related LT is rare, but may be critical and even life-threatening. Physicians should be aware of potential trimethoprim/sulfamethoxazole-related LT and should inform their patients, since early intervention could prevent severe outcome.</p>","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"1148-1152"},"PeriodicalIF":3.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amino acid substitutions in PBP3 in Haemophilus influenzae strains, their phenotypic detection and impact on resistance to β-lactams.","authors":"Vladislav Jakubu, Marketa Cechova, Martin Musilek, Lucia Malisova, Barbora Zapletalova, Helena Zemlickova","doi":"10.1093/jac/dkaf023","DOIUrl":"10.1093/jac/dkaf023","url":null,"abstract":"<p><strong>Background: </strong>Data from surveillance on antibiotic resistance have shown an increasing prevalence of non-enzymatic resistance (β-lactamase-negative ampicillin-resistant) to β-lactam antibiotics among H. influenzae strains in the Czech Republic. Aminopenicillins are recommended agents for non-invasive Haemophilus influenzae infections. The phenomenon of non-enzymatic resistance to β-lactams is complicated by the fact that the phenotypic detection of PBP3 with specific amino acid substitutions (rPBP3) is challenging, since rPBP3 isolates have repeatedly been demonstrated to be split by the epidemiological cut-off values (ECOFF) for aminopenicillins defined by EUCAST.</p><p><strong>Objectives: </strong>We sought to determine whether the penicillin disc has sufficient detection ability to predict the non-enzymatic mechanism; whether other antibiotics can be used for detection; and what is the agreement between the broth microdilution and disc diffusion methods.</p><p><strong>Methods: </strong>We undertook susceptibility testing of selected antibiotics according to EUCAST of 153 rPBP3 strains, and sequencing of the ftsI gene to determination amino acid substitutions.</p><p><strong>Results: </strong>For a selected set of rPBP strains: (i) the detection capability for penicillin, ampicillin, cefuroxime and amoxicillin/clavulanate was found to be 91.5%, 94.4%, 89.5% and 70.6%, respectively; (ii) the categorical agreement between the disc diffusion method and the MIC for ampicillin and cefuroxime was 71.1% and 83.8%, respectively.</p><p><strong>Conclusions: </strong>We observed better recognition of rPBP3 strains by the ampicillin disc than by the penicillin disc. There is frequently a discrepancy in the interpretation of susceptibility results between the methods used.</p>","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"980-987"},"PeriodicalIF":3.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of trimethoprim-sulfamethoxazole versus minocycline monotherapy for treatment of Stenotrophomonas maltophilia pneumonia.","authors":"Emily T Graves, Lynn Wardlow, Stella Ogake, Jose A Bazan, Kelci Coe, Kaitlyn Kuntz, Jessica L Elefritz","doi":"10.1093/jac/dkaf024","DOIUrl":"10.1093/jac/dkaf024","url":null,"abstract":"<p><strong>Objective: </strong>To compare the rate of clinical cure and adverse effects in patients receiving definitive treatment with trimethoprim-sulfamethoxazole versus minocycline monotherapy for Stenotrophomonas maltophilia pneumonia.</p><p><strong>Methods: </strong>A single-centre, retrospective cohort study of patients with S. maltophilia pneumonia admitted 1 March 2018-30 September 2023 was conducted comparing treatment with trimethoprim-sulfamethoxazole versus minocycline monotherapy. The primary outcome was the rate of clinical cure, defined as meeting two of the three prespecified criteria for a period of 48 hours while on definitive therapy: normalization of white blood cell count, absence of fever and hypothermia and decreased oxygen support. Secondary outcomes evaluated included time to clinical cure, infection-related and in-hospital mortality, pneumonia recurrence and incidence of adverse effects, which was a composite of acute kidney injury (AKI), hyperkalaemia and thrombocytopenia.</p><p><strong>Results: </strong>Of 93 patients included, 48 received trimethoprim-sulfamethoxazole and 45 received minocycline. There was no difference in the primary outcome of clinical cure between the trimethoprim-sulfamethoxazole and minocycline groups (72.9% versus 66.7%, P = 0.51). S. maltophilia pneumonia recurrence was more common in the minocycline group compared to the trimethoprim-sulfamethoxazole group (35.6% versus 10.4%, P = 0.006). In-hospital mortality was higher in the trimethoprim-sulfamethoxazole group although there was no difference in infection-related in-hospital mortality (6.3% versus 2.3%, P = 0.62). The incidence of AKI, hyperkalaemia and thrombocytopenia did not differ between groups.</p><p><strong>Conclusion: </strong>There was no difference in clinical cure rate for S. maltophilia pneumonia treatment between trimethoprim-sulfamethoxazole and minocycline monotherapy although higher rates of recurrent pneumonia were observed in patients treated with minocycline. Rates of adverse effects were similar between groups.</p>","PeriodicalId":14969,"journal":{"name":"Journal of Antimicrobial Chemotherapy","volume":" ","pages":"988-995"},"PeriodicalIF":3.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}