P-1358. Efficacy of combination therapy with minocycline for the treatment of Stenotrophomonas maltophilia infections
Abstract
Abstract Background Stenotrophomonas maltophilia is a multidrug-resistant bacterium that causes high in-hospital mortality worldwide. However, published data on the utility of combination therapy for S. maltophilia infections remain limited. Methods We enrolled adult patients with S. maltophilia infection in a randomized, double-blind, placebo-controlled, single-center clinical trial at Siriraj Hospital, Thailand. Patients were assigned 1:1 to receive minocycline capsules (100 mg twice daily) in combination with either levofloxacin or trimethoprim-sulfamethoxazole or monotherapy with either levofloxacin or trimethoprim-sulfamethoxazole. The study outcomes were 28-day mortality, clinical and microbiological responses, and adverse events. The favorable microbiological outcome was that the previously identified pathogen was not detected, and no new pathogen was detected. Results Between 2022 and 2024, 112 patients were randomly assigned to combination therapy (n = 55) or monotherapy (n = 57). Most patients were in the intensive care unit at the time of enrollment (71.4%). There was no difference in 28-day mortality between groups (43.6% combination therapy vs 38.6% monotherapy, p = 0.59). Patients on combination therapy had significantly more favorable microbiological outcomes than patients on monotherapy 72 hours after treatment (45.5% on combination therapy vs 14% on monotherapy, p < 0.001) and at the end of treatment (80% on combination therapy vs 56.1% on monotherapy, p =…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 65 participants or records.
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