Stenotrophomonas maltophilia

Stenotrophomonas maltophilia


See 'Additional Information'

General Information

TMP-SMX 8-12 mg/kg/day (TMP component) IV/PO divided q8-12h (consider maximum dose of 960 mg TMP component per day).

  • For weight ~70kg: 15 mL IV q8h or 1-2 DS tabs TID
    • 1 mL = 16 mg TMP
    • 1 DS tab = 160 mg TMP

Consider combination therapy with the addition of a second agent (minocycline [preferred], tigecycline, levofloxacin, or cefiderocol) if there is a delay in clinical improvement with TMP-SMX alone or severe infection.

If susceptible to Levofloxacin, should not be used as a single agent.

Do NOT use ceftazidime (even if reported as susceptible).

Aerobic non-fermenting gram negative rod

  • May be acquired from diverse environmental sources (e.g. tap water)
  • Intubated patients or those with lung disease (bronchiectasis, cystic fibrosis) may be colonized
  • Must distinguish colonization from clinically significant infection

Most common reason for isolation is colonization of the respiratory tract.

Most common true infections:

  • Line-associated bloodstream infections
  • Hospital acquired pneumonia

May require contact precautions.

True pneumonia more likely in ICU and oncology patients, those with advanced age and after/during treatment with broad spectrum antimicrobial use.