Propensity-Matched Comparison of Timely vs Delayed Antibiotic Therapy in Stenotrophomonas maltophilia Pneumonia
Abstract
Abstract Background Stenotrophomonas maltophilia, a multidrug-resistant nosocomial pathogen, is associated with high mortality and therapeutic challenges due to resistance. Empiric Gram-negative antibiotic regimens often lack activity against S. maltophilia, delaying effective therapy. This study evaluated timely versus delayed antibiotic therapy's impact on clinical outcomes in S. maltophilia pneumonia patients. Methods This retrospective cohort study included adults hospitalized with S. maltophilia pneumonia at the University of Kentucky HealthCare (2014–2023). Patients received active monotherapy or combination therapy with trimethoprim/sulfamethoxazole, minocycline, or levofloxacin. Timely therapy was defined as initiation ≤48 hours from index culture collection; delayed therapy as >48 hours. Propensity score matching minimized baseline differences. The Desirability of Outcome Ranking (DOOR) framework evaluated outcomes, prioritizing clinical efficacy and safety. Kaplan–Meier analysis assessed 30-day mortality. A Cox proportional hazards model with time-dependent covariates assessed therapy timing, adjusting for calendar year and COVID-19 time period. Results Of 430 patients (215 per group), DOOR analysis showed a 72.8% probability (95% CI, 67.9%–77.1%; P < .001) that timely therapy resulted in patients being alive with fewer or no clinical events. Kaplan–Meier analysis confirmed higher survival with timely therapy (log-rank P < .001), with a 22.8% absolute reduction in…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 430 participants or records.
Read the paper
Related studies
- Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching
- Thiophenes—Naturally Occurring Plant Metabolites: Biological Activities and In Silico Evaluation of Their Potential as Cathepsin D Inhibitors
- Inhalable Mannosylated Rifampicin–Curcumin Co-Loaded Nanomicelles with Enhanced In Vitro Antimicrobial Efficacy for an Optimized Pulmonary Tuberculosis Therapy
- Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
- GC-MS Analysis and Biomedical Therapy of Oil from n-Hexane Fraction of Scutellaria edelbergii Rech. f.: In Vitro, In Vivo, and In Silico Approach
- Novel Pharmacokinetic/Pharmacodynamic Parameters Quantify the Exposure–Effect Relationship of Levofloxacin against Fluoroquinolone-Resistant Escherichia coli
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.