Optimizing antibiotic therapy for stenotrophomonas maltophilia infections in critically Ill patients: A pharmacokinetic/pharmacodynamic approach

Stenotrophomonas maltophilia is an opportunistic, multidrug-resistant non-fermentative Gram-negative bacillus, posing a significant challenge in clinical treatment due to its numerous intrinsic and acquired resistance mechanisms. This study aimed to evaluate the adequacy of antibiotics used for the...

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Autores: Barrasa González, Helena, Morán Rodríguez, Miguel Ángel, Fernández Ciriza, Leire, Isla Ruiz, Arantxazu, Solinís Aspiazu, María Ángeles, Canut Blasco, Andrés, Rodríguez Gascón, Alicia
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universidad del País Vasco
Repositorio:Addi. Archivo Digital para la Docencia y la Investigación
OAI Identifier:oai:addi.ehu.eus:10810/68696
Acceso en línea:http://hdl.handle.net/10810/68696
Access Level:acceso abierto
Palabra clave:Stenotrophomonas maltophilia
PK/PD
cotrimoxazole
levofloxacin
minocycline
tigecycline
aztreonam/avibactam
cefiderocol
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spelling Optimizing antibiotic therapy for stenotrophomonas maltophilia infections in critically Ill patients: A pharmacokinetic/pharmacodynamic approachBarrasa González, HelenaMorán Rodríguez, Miguel ÁngelFernández Ciriza, LeireIsla Ruiz, ArantxazuSolinís Aspiazu, María ÁngelesCanut Blasco, AndrésRodríguez Gascón, AliciaStenotrophomonas maltophiliaPK/PDcotrimoxazolelevofloxacinminocyclinetigecyclineaztreonam/avibactamcefiderocolStenotrophomonas maltophilia is an opportunistic, multidrug-resistant non-fermentative Gram-negative bacillus, posing a significant challenge in clinical treatment due to its numerous intrinsic and acquired resistance mechanisms. This study aimed to evaluate the adequacy of antibiotics used for the treatment of S. maltophilia infections in critically ill patients using a pharmacokinetic/pharmacodynamic (PK/PD) approach. The antibiotics studied included cotrimoxazole, levofloxacin, minocycline, tigecycline, cefiderocol, and the new combination aztreonam/avibactam, which is not yet approved. By Monte Carlo simulations, the probability of target attainment (PTA), the PK/PD breakpoints, and the cumulative fraction of response (CFR) were estimated. PK parameters and MIC distributions were sourced from the literature, the European Committee on Antimicrobial Susceptibility Testing (EUCAST), and the SENTRY Antimicrobial Surveillance Program collection. Cefiderocol 2 g q8h, minocycline 200 mg q12h, tigecycline 100 mg q12h, and aztreonam/avibactam 1500/500 mg q6h were the best options to treat empirically infections due to S. maltophilia. Cotrimoxazole provided a higher probability of treatment success for the U.S. isolates than for European isolates. For all antibiotics, discrepancies between the PK/PD breakpoints and the clinical breakpoints defined by EUCAST (or the ECOFF) and CLSI were detected.This research was funded by the Basque Government (IT1587-22).MDPI2024202420242024info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10810/68696reponame:Addi. Archivo Digital para la Docencia y la Investigacióninstname:Universidad del País VascoIngléshttps://www.mdpi.com/2079-6382/13/6/553info:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by/4.0/es/© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/ 4.0/).oai:addi.ehu.eus:10810/686962026-06-18T09:23:17Z
dc.title.none.fl_str_mv Optimizing antibiotic therapy for stenotrophomonas maltophilia infections in critically Ill patients: A pharmacokinetic/pharmacodynamic approach
title Optimizing antibiotic therapy for stenotrophomonas maltophilia infections in critically Ill patients: A pharmacokinetic/pharmacodynamic approach
spellingShingle Optimizing antibiotic therapy for stenotrophomonas maltophilia infections in critically Ill patients: A pharmacokinetic/pharmacodynamic approach
Barrasa González, Helena
Stenotrophomonas maltophilia
PK/PD
cotrimoxazole
levofloxacin
minocycline
tigecycline
aztreonam/avibactam
cefiderocol
title_short Optimizing antibiotic therapy for stenotrophomonas maltophilia infections in critically Ill patients: A pharmacokinetic/pharmacodynamic approach
title_full Optimizing antibiotic therapy for stenotrophomonas maltophilia infections in critically Ill patients: A pharmacokinetic/pharmacodynamic approach
title_fullStr Optimizing antibiotic therapy for stenotrophomonas maltophilia infections in critically Ill patients: A pharmacokinetic/pharmacodynamic approach
title_full_unstemmed Optimizing antibiotic therapy for stenotrophomonas maltophilia infections in critically Ill patients: A pharmacokinetic/pharmacodynamic approach
title_sort Optimizing antibiotic therapy for stenotrophomonas maltophilia infections in critically Ill patients: A pharmacokinetic/pharmacodynamic approach
dc.creator.none.fl_str_mv Barrasa González, Helena
Morán Rodríguez, Miguel Ángel
Fernández Ciriza, Leire
Isla Ruiz, Arantxazu
Solinís Aspiazu, María Ángeles
Canut Blasco, Andrés
Rodríguez Gascón, Alicia
author Barrasa González, Helena
author_facet Barrasa González, Helena
Morán Rodríguez, Miguel Ángel
Fernández Ciriza, Leire
Isla Ruiz, Arantxazu
Solinís Aspiazu, María Ángeles
Canut Blasco, Andrés
Rodríguez Gascón, Alicia
author_role author
author2 Morán Rodríguez, Miguel Ángel
Fernández Ciriza, Leire
Isla Ruiz, Arantxazu
Solinís Aspiazu, María Ángeles
Canut Blasco, Andrés
Rodríguez Gascón, Alicia
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Stenotrophomonas maltophilia
PK/PD
cotrimoxazole
levofloxacin
minocycline
tigecycline
aztreonam/avibactam
cefiderocol
topic Stenotrophomonas maltophilia
PK/PD
cotrimoxazole
levofloxacin
minocycline
tigecycline
aztreonam/avibactam
cefiderocol
description Stenotrophomonas maltophilia is an opportunistic, multidrug-resistant non-fermentative Gram-negative bacillus, posing a significant challenge in clinical treatment due to its numerous intrinsic and acquired resistance mechanisms. This study aimed to evaluate the adequacy of antibiotics used for the treatment of S. maltophilia infections in critically ill patients using a pharmacokinetic/pharmacodynamic (PK/PD) approach. The antibiotics studied included cotrimoxazole, levofloxacin, minocycline, tigecycline, cefiderocol, and the new combination aztreonam/avibactam, which is not yet approved. By Monte Carlo simulations, the probability of target attainment (PTA), the PK/PD breakpoints, and the cumulative fraction of response (CFR) were estimated. PK parameters and MIC distributions were sourced from the literature, the European Committee on Antimicrobial Susceptibility Testing (EUCAST), and the SENTRY Antimicrobial Surveillance Program collection. Cefiderocol 2 g q8h, minocycline 200 mg q12h, tigecycline 100 mg q12h, and aztreonam/avibactam 1500/500 mg q6h were the best options to treat empirically infections due to S. maltophilia. Cotrimoxazole provided a higher probability of treatment success for the U.S. isolates than for European isolates. For all antibiotics, discrepancies between the PK/PD breakpoints and the clinical breakpoints defined by EUCAST (or the ECOFF) and CLSI were detected.
publishDate 2024
dc.date.none.fl_str_mv 2024
2024
2024
2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/10810/68696
url http://hdl.handle.net/10810/68696
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv https://www.mdpi.com/2079-6382/13/6/553
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
http://creativecommons.org/licenses/by/4.0/es/
eu_rights_str_mv openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/es/
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Addi. Archivo Digital para la Docencia y la Investigación
instname:Universidad del País Vasco
instname_str Universidad del País Vasco
reponame_str Addi. Archivo Digital para la Docencia y la Investigación
collection Addi. Archivo Digital para la Docencia y la Investigación
repository.name.fl_str_mv
repository.mail.fl_str_mv
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