Why carry out this study?

Stenotrophomonas maltophilia has emerged as an important hospital-acquired pathogen in critically ill patients, and therapeutic options for its infections are limited because of its extensive antimicrobial resistance.

Trimethoprim-sulfamethoxazole and fluoroquinolones are widely used in treating S. maltophilia infections. However, because of the high rate of adverse events and the increasing rate of antimicrobial resistance, alternative antibiotics are urgently needed.

Tigecycline is a potential alternative for S. maltophilia infections due to its potent in vitro activity. However, studies assessing the effect of tigecycline in treating S. maltophilia infections are limited.

What was learned from the study?

Compared with fluoroquinolones, the standard dose of tigecycline therapy resulted in worse clinical outcomes, with a lower rate of clinical and microbiological cure but no statistical difference in 28-day mortality in patients with ventilator-associated pneumonia caused by S. maltophilia.

We recommend against using the standard dose of tigecycline in the treatment of S. maltophilia ventilator-associated pneumonia unless new clinical evidence emerges.