Monotherapy versus combination for the treatment of Stenotrophomonas maltophilia: a multicenter cohort study.

IF 4.2 2区医学 Q1 INFECTIOUS DISEASES Expert Review of Anti-infective Therapy Pub Date : 2024-05-13 DOI:10.1080/14787210.2024.2353704

Thamer A Almangour, Hussain A Alali, Zakiyah Alkherb, Shuroug A Alowais, Khalid Bin Saleh, Sara Almuhisen, Abdullah Almohaizeie, Renad Alsahli, Shatha Alruwaite, Fai Alnashmi, Lolwa Fetyani, Noran Ibrahim Abouobaid, Alnajla Alghofaily, Khalifa M Binkhamis, Yazed Saleh Alsowaida

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Abstract

Background: The aim of this study was to compare the safety and effectiveness of monotherapy versus combination therapy for the treatment of infections caused by S. maltophilia.

Methods: This retrospective, multicenter, cohort study included patients treated with either monotherapy or combination therapy for infections caused by S. maltophilia. Primary outcomes included overall in-hospital mortality, 30-day mortality, and clinical cure. Safety outcomes were also evaluated. Multivariable logistic regression was used as a control for confounding variables.

Results: A total of 407 patients were included, 330 patients received monotherapy and 77 patients received combination therapy. A total of 21% presented with concomitant bacteremia. After adjusting the differences between the two groups, there were no statistically significant differences between patients who received monotherapy versus combination therapy in clinical cure (55% vs 65%; OR, 0.72; 95% CI, 0.40-1.31) and overall in-hospital mortality (52% vs 49%; OR, 0.84; 95% CI, 0.45-1.57). However, patients who received monotherapy had a lower rate of 30-day mortality (28% vs 32%; OR, 0.45; 95% CI, 0.22-0.90) and acute kidney injury (9% vs 18%; OR, 0.35; 95% CI, 0.16-0.78).

Conclusion: Clinical outcomes did not significantly differ in patients who received combination therapy versus monotherapy. More data are needed to validate these findings.

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单药与联合用药治疗嗜麦芽霉单胞菌病：一项多中心队列研究。

背景：本研究旨在比较单一疗法和联合疗法治疗嗜麦芽糖浆菌感染的安全性和有效性：本研究的目的是比较单一疗法与联合疗法治疗嗜麦芽糖酵母菌感染的安全性和有效性：这项回顾性、多中心、队列研究纳入了接受单一疗法或联合疗法治疗的嗜麦芽糖病菌感染患者。主要结果包括住院总死亡率、30 天死亡率和临床治愈率。同时还评估了安全性结果。多变量逻辑回归用于控制混杂变量：共纳入 407 名患者，其中 330 名患者接受了单一疗法，77 名患者接受了联合疗法。共有21%的患者同时出现菌血症。调整两组之间的差异后，接受单一疗法和联合疗法的患者在临床治愈率（55% vs 65%；OR，0.72；95% CI，0.40-1.31）和院内总死亡率（52% vs 49%；OR，0.84；95% CI，0.45-1.57）方面没有显著统计学差异。然而，接受单一疗法的患者的30天死亡率（28% vs 32%；OR，0.45；95% CI，0.22-0.90）和急性肾损伤率（9% vs 18%；OR，0.35；95% CI，0.16-0.78）较低：结论：接受联合疗法和单一疗法的患者的临床结果没有明显差异。结论：接受联合疗法和单一疗法的患者的临床结果没有明显差异，需要更多数据来验证这些发现。

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来源期刊

Expert Review of Anti-infective Therapy 医学-药学

CiteScore

11.20

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.