Falagas Matthew E, Valkimadi Politimi-Eleni, Huang Yu-Tsung, Matthaiou Dimitrios K, Hsueh Po-Ren
Alfa Institute of Biomedical Sciences, Athens, Greece.
J Antimicrob Chemother. 2008 Nov;62(5):889-94. doi: 10.1093/jac/dkn301. Epub 2008 Jul 28.
Stenotrophomonas maltophilia has emerged as an important opportunistic pathogen, causing infections whose management is often problematic due to its inherent resistance to many antibiotics, making co-trimoxazole the main therapeutic option. However, there are cases in which either due to antimicrobial resistance or allergic reactions and intolerance to co-trimoxazole this antibiotic cannot be administered. We sought to evaluate the available clinical evidence regarding potentially effective alternative antibiotics for the treatment of S. maltophilia infections.
The literature search was performed in the PubMed and Scopus databases. The search string used was 'Stenotrophomonas maltophilia OR Xanthomonas maltophilia'.
Thirty-one case reports and 5 case series were retrieved including a total of 49 patients with a variety of infections. Twenty of 49 cases (40.8%) were treated with ciprofloxacin as monotherapy or in combination with other antibiotics; 12 of 49 cases (24.5%) were treated with ceftriaxone- or ceftazidime-based regimens; and 6 of 49 cases (12.2%) were treated with ticarcillin- or ticarcillin/clavulanate-based regimens. The cure or improvement rates were 18 cases (90%), 8 (75%) and 4 (66.7%), respectively. The remaining 11 patients received various antimicrobials including aminoglycoside-based regimens, carbapenems, levofloxacin, chloramphenicol, aztreonam, minocycline and other beta-lactams.
The limited available data suggest that ciprofloxacin, ceftazidime or ceftriaxone, and ticarcillin/clavulanate, alone or in combination with other antibiotics, may be considered as alternative options beyond co-trimoxazole.
嗜麦芽窄食单胞菌已成为一种重要的机会致病菌，因其对多种抗生素具有固有耐药性，导致其所致感染的治疗常常存在问题，这使得复方新诺明成为主要的治疗选择。然而，在某些情况下，由于抗菌药物耐药性或过敏反应以及对复方新诺明不耐受，无法使用这种抗生素。我们试图评估关于治疗嗜麦芽窄食单胞菌感染的潜在有效替代抗生素的现有临床证据。
在PubMed和Scopus数据库中进行文献检索。使用的检索词为“嗜麦芽窄食单胞菌或嗜麦芽黄单胞菌”。
检索到31篇病例报告和5个病例系列，共包括49例患有各种感染的患者。49例病例中的20例（40.8%）接受环丙沙星单药治疗或与其他抗生素联合治疗；49例病例中的12例（24.5%）接受基于头孢曲松或头孢他啶的治疗方案；49例病例中的6例（12.2%）接受基于替卡西林或替卡西林/克拉维酸的治疗方案。治愈率或改善率分别为18例（90%）、8例（75%）和4例（66.7%）。其余11名患者接受了各种抗菌药物治疗，包括基于氨基糖苷类的治疗方案、碳青霉烯类、左氧氟沙星、氯霉素、氨曲南、米诺环素和其他β-内酰胺类药物。
有限的现有数据表明，环丙沙星、头孢他啶或头孢曲松以及替卡西林/克拉维酸，单独使用或与其他抗生素联合使用，可被视为复方新诺明之外的替代选择。
