Al Musawa Mohammed, Kunz Coyne Ashlan J, Alosaimy Sara, Lucas Kristen, Schrack Melanie Rae, Andrade Justin, Herbin Shelbye R, Biagi Mark, Pierce Michael, Molina Kyle C, Perkins Nicholson B, Cosimi Reese, Kang-Birken Lena, King Madeline A, Pullinger Benjamin M, Rojas Leonor M, Bouchard Jeannette, Hobbs Athena L V, Agee Jazmin, Caniff Kaylee E, Van Helden Sean R, Veve Michael P, Rybak Michael J
Anti-Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA.
University of Kentucky College of Pharmacy, Lexington, KY, USA.
Infect Dis Ther. 2025 Jun 6. doi: 10.1007/s40121-025-01170-x.
Stenotrophomonas maltophilia is notable for its rising incidence and multidrug resistance, which complicates treatment. As a result of insufficient clinical studies, the 2024 Infectious Diseases Society of America (IDSA) Guidance on Treating Antimicrobial Resistant Gram-negative Infection advises against using eravacycline (ERV) for S. maltophilia infections. We present real-world data on patients treated with ERV for these infections.
This multicenter, retrospective, observational study included adult patients who received ERV for treating S. maltophilia infections for ≥ 72 h between October 2018 and August 2022. The primary outcome was the clinical cure evaluated at the end of ERV therapy. Key secondary outcomes included a 30-day survival rate, absence of infection recurrence counting from the end of ERV therapy, and occurrence of possible ERV-related adverse effects (AE) noted in the patient's records.
Overall, 41 patients were included with a median (interquartile range [IQR]) age of 63 years (46.0-74.5). Most patients were male (63.4%) and white (51.2%). The primary source of infection was pulmonary (56.1%), and most patients received ERV for regimen consolidation (65.9%). Combination therapy was used in about 10% of the cases for S. maltophilia treatment. The median (IQR) duration of ERV treatment was 7 days (4.0-11.5). The clinical cure rate was 73.2%, and the 30-day survival rate was 68.3%. Four patients (9.8%) experienced possible AE from ERV.
S. maltophilia infections are challenging to treat because of limited options. An analysis of 41 patients indicates ERV may be an acceptable treatment option, but more clinical studies are needed to evaluate its efficacy and safety.
嗜麦芽窄食单胞菌的发病率不断上升且具有多重耐药性，这使得治疗变得复杂。由于临床研究不足，美国传染病学会（IDSA）2024年《治疗耐抗菌药物革兰氏阴性菌感染指南》建议不要使用依拉环素（ERV）治疗嗜麦芽窄食单胞菌感染。我们展示了使用ERV治疗这些感染患者的真实世界数据。
这项多中心、回顾性、观察性研究纳入了2018年10月至2022年8月期间接受ERV治疗嗜麦芽窄食单胞菌感染≥72小时的成年患者。主要结局是在ERV治疗结束时评估的临床治愈情况。关键次要结局包括30天生存率、从ERV治疗结束起计算的无感染复发情况以及患者记录中 noted的可能的ERV相关不良反应（AE）的发生情况。
总体而言，纳入了41例患者，中位（四分位间距[IQR]）年龄为63岁（46.0 - 74.5）。大多数患者为男性（63.4%）且为白人（51.2%）。感染的主要来源是肺部（56.1%），大多数患者接受ERV用于方案巩固（65.9%）。约10%的病例在治疗嗜麦芽窄食单胞菌时使用了联合治疗。ERV治疗的中位（IQR）持续时间为7天（4.0 - 11.5）。临床治愈率为73.2%，30天生存率为68.3%。4例患者（9.8%）经历了可能由ERV引起的AE。
由于治疗选择有限，嗜麦芽窄食单胞菌感染难以治疗。对41例患者的分析表明，ERV可能是一种可接受的治疗选择，但需要更多临床研究来评估其疗效和安全性。
