Assessment of the relative benefits of monotherapy and combination therapy approaches to the treatment of hospital-acquired Stenotrophomonas maltophilia pneumonia: a multicenter, observational, real-world study

Chen, L; Hua, J; Hong, S; Yuan, C; Jing, R; Luo, X; Zhu, Y; Le, L; Wang, Z; Sun, X; He, X

doi:10.1186/s13613-023-01144-7

Sepsis & infection

Assessment of the relative benefits of monotherapy and combination therapy approaches to the treatment of hospital-acquired Stenotrophomonas maltophilia pneumonia: a multicenter, observational, real-world study

Ann Intensive CarePublished 6 Jun 2023Retrospective cohort study

Main finding · 30-day mortalityResultOdds ratio 1.124 95% CI 0.707–1.786

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Authors' conclusion

The present data suggest that when treating S. maltophilia-HAP, immunocompromised patients and individuals with APACHE II scores ≥ 15 may potentially benefit from combination therapy.

Study context

Population: Patients with S. maltophilia hospital-acquired pneumonia in four Chinese teaching hospitals, 2016–2022
Participants: 307 patients · 4 hospitals

Exposure: Combination vs monotherapy definitive therapy
Combinationn = 171
Outcome: All-cause mortality
Follow-up: 30 days

Methodological detailsmulticentre, propensity score weighting

Multicentre
Propensity score weighting

Main finding

30-day mortality

Odds ratio

1.124

95% CI 0.707–1.786

P = 0.622

Combination vs Monotherapy

OR 1.124 (95% CI 0.707–1.786); P = 0.622

As reported in the abstract

Observational data: associations, not effects.

Further findings

Outcome	← Lower odds with combination ←→ Higher odds with combination →	OR (95% CI)	P value
30-day mortality (subgroup: immunocompetent)	0.10.31310	1.349 (0.712–2.554)	P = 0.359
30-day mortality (subgroup: APACHE II < 15)	0.10.31310	2.357 (0.820–6.677)	P = 0.111
30-day mortality (subgroup: immunocompromised)	0.10.31310	0.404 (.170-0.962)	P = 0.041
30-day mortality (subgroup: APACHE II ≥ 15)	0.10.31310	0.494 (0.256–0.951)	P = 0.035
	0.10.31310Odds ratio (log scale)

30-day all-cause mortality, whole cohort

Overall 30-day all-cause mortality: 41.0% (126/307)

Original publication

Assessment of the relative benefits of monotherapy and combination therapy approaches to the treatment of hospital-acquired Stenotrophomonas maltophilia pneumonia: a multicenter, observational, real-world study. Ann Intensive Care. Published 6 June 2023. doi:10.1186/s13613-023-01144-7

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