Combination therapy may be effective against Stenotrophomonas maltophilia
Stenotrophomonas maltophilia is a non-fermenting gram-negative bacterium, an important causative agent of nosocomial infections, which has been increasingly isolated in recent years and is a serious problem for clinicians due to its profile special and its multiple resistance to antimicrobial agents (AMP). S. maltophilia sensitivity detection methods for AMP often give inaccurate results and require further improvement. S. maltophilia is generally insensitive to anti-Pseudomonas penicillins and cephalosporins, aminoglycosides, "classic" fluoroquinolones and carbapenems, and it is recommended to use cotrimoxazole (trimethoprim / sulfamethiclazoline or trimethoprimazoline) for the treatment of infections caused by this pathogen. The importance of alternative MPAs, and their combinations, for the treatment of infections caused by S. maltophilia, is for further study.
In an in vitro study using E-tests, it was found that the sensitivity indicators of S. maltophilia for various SAPs: 35% for ceftazidime, 10% for chloramphenicol, 95% for minocycline, 35% for ticarcillin / clavulanate and 100% for cotrimoxazole. The combination of meropenem with levofloxacin showed synergy in 60% of S. maltophilia. The mechanism of the synergistic effect of meropenem and levofloxacin in vitro is currently unknown. Nevertheless, the in vitro data obtained allow us to hope for favorable results from the use of this combination of antibacterial drugs in the treatment of infections caused by this pathogen in clinical practice. Given the limited possibilities for effective antibiotic therapy in patients with nosocomial infections caused by multidrug-resistant S. maltophilia strains, other clinical trials of the efficacy of combinations of MPAs that have shown synergy in vitro vis-à-vis this pathogen are necessary.