Tigecycline as a therapeutic option in Stenotrophomonas maltophilia infections

Abstract

Trimethoprim-sulfamethoxazole (TMP-SMZ) is recommended as the treatment of choice for Stenotrophomonas maltophilia infections. However, when the administration of TMP-SMZ is not possible, alternative treatment options for S. maltophilia infections has not been clearly established. We compare the efficacy of tigecycline treatment with TMP-SMZ in nosocomial S. maltophilia infections during a 3-year period. For the treatment of S. maltophilia infection, 26 (57·8%) patients received TMP-SMZ and 19 (42·2%) patients received tigecycline. Culture positivity rate was 95·7% in TMP-SMZ group and 70·6% in tigecycline group at the seventh day (P = 0·028), whereas 26·3% versus 18·8% at the fourteenth day (P = 0·700). Clinical improvement was observed 69·2% in TMP-SMZ group and 68·4% in tigecycline group at the fourteenth day (P = 0·954). Mortality rates at the thirtieth day were respectively, 30·8 and 21·1% in TMP-SMZ and tigecycline groups (P = 0·517). There were no significant differences in mortality and clinical response rates between TMP-SMZ and tigecycline treatment. Tigecycline can be considered as an alternative option beyond TMP-SMZ in treatment of S. maltophilia infections.

Keywords:

• Tigecycline
• Stenotrophomonas maltophilia
• Trimethoprim-sulfamethoxazole
• Treatment

The study was presented as a poster in 21st European Congress of Clinical Microbiology and Infectious Diseases and the 27th International Congress of Chemotherapy in Milan in 2011.