Clinical Outcomes of Eravacycline in Patients Treated for Stenotrophomonas maltophilia Infections

Mohammed Al Musawa; Ashlan J. Kunz Coyne; Sara Alosaimy; Kristen Lucas; Melanie Rae Schrack; Justin Andrade; Shelbye R. Herbin; Mark Biagi; Michael Pierce; Kyle C. Molina; Nicholson B. Perkins; Reese Cosimi; Lena Kang-Birken; Madeline A. King; Benjamin M. Pullinger; Leonor M. Rojas; Jeannette Bouchard; Athena L.V. Hobbs; Jazmin Agee; Kaylee E. Caniff; Sean R. Van Helden; Michael P. Veve; Michael J. Rybak

doi:10.1007/s40121-025-01170-x

Clinical Outcomes of Eravacycline in Patients Treated for Stenotrophomonas maltophilia Infections

Mohammed Al Musawa, Ashlan J. Kunz Coyne, Sara Alosaimy, Kristen Lucas, Melanie Rae Schrack, Justin Andrade, Shelbye R. Herbin, Mark Biagi, Michael Pierce, Kyle C. Molina, Nicholson B. Perkins, Reese Cosimi, Lena Kang-Birken, Madeline A. King, Benjamin M. Pullinger, Leonor M. Rojas, Jeannette Bouchard, Athena L.V. Hobbs, Jazmin Agee, Kaylee E. CaniffSean R. Van Helden, Michael P. Veve, Michael J. Rybak

Pharmacy Practice and Science

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction: Stenotrophomonas maltophilia is notable for its rising incidence and multidrug resistance, which complicates treatment. As a result of insufficient clinical studies, the 2024 Infectious Diseases Society of America (IDSA) Guidance on Treating Antimicrobial Resistant Gram-negative Infection advises against using eravacycline (ERV) for S. maltophilia infections. We present real-world data on patients treated with ERV for these infections. Methods: This multicenter, retrospective, observational study included adult patients who received ERV for treating S. maltophilia infections for ≥ 72 h between October 2018 and August 2022. The primary outcome was the clinical cure evaluated at the end of ERV therapy. Key secondary outcomes included a 30-day survival rate, absence of infection recurrence counting from the end of ERV therapy, and occurrence of possible ERV-related adverse effects (AE) noted in the patient’s records. Results: Overall, 41 patients were included with a median (interquartile range [IQR]) age of 63 years (46.0–74.5). Most patients were male (63.4%) and white (51.2%). The primary source of infection was pulmonary (56.1%), and most patients received ERV for regimen consolidation (65.9%). Combination therapy was used in about 10% of the cases for S. maltophilia treatment. The median (IQR) duration of ERV treatment was 7 days (4.0–11.5). The clinical cure rate was 73.2%, and the 30-day survival rate was 68.3%. Four patients (9.8%) experienced possible AE from ERV. Conclusion: S. maltophilia infections are challenging to treat because of limited options. An analysis of 41 patients indicates ERV may be an acceptable treatment option, but more clinical studies are needed to evaluate its efficacy and safety.

Original language	English
Journal	Infectious Diseases and Therapy
DOIs	https://doi.org/10.1007/s40121-025-01170-x
State	Accepted/In press - 2025

Bibliographical note

Publisher Copyright:
© The Author(s) 2025.

Funding

Michael J. Rybak declares that he has received research grant support, has spoken on behalf of or consulted for AbbVie, Innoviva, Melinta, Merck, and Shionogi. Michael J. Rybak is an Editor-in-Chief of Infectious Diseases and Therapy. Michael J. Rybak was not involved in the selection of peer reviewers for the manuscript nor any of the subsequent editorial decisions. Ashlan J. Kunz Coyne declares that she served on an advisory board for AbbVie. Kyle C. Molina declares that he serves as consultant for Melinta, Shionogi, Innoviva Specialty Therapeutics, and Merck and received grants from Melinta and Merck. Michael P. Veve declares that he has received funding from and/or consulted for Innoviva Specialty Therapeutics, Inc. Mohammed Al Musawa, Sara Alosaimy, Kristen Lucas, Melanie Rae Schrack, Justin Andrade, Shelbye R. Herbin, Mark Biagi, Michael Pierce, Nicholson B. Perkins III, Reese Cosimi, Lena Kang-Birken, Madeline A. King, Benjamin M. Pullinger, Leonor M. Rojas, Jeannette Bouchard, Tristan Gore, Athena L.V. Hobbs, Jazmin Agee, Kaylee E. Caniff, and Sean R. Van Helden declare that they have no competing interests.

Funders	Funder number
Innoviva Specialty Therapeutics, Inc.

Keywords

Antimicrobial resistance
Drug resistance
Eravacycline
Gram-negative
Stenotrophomonas maltophilia

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1007/s40121-025-01170-x

Cite this

Al Musawa, M., Kunz Coyne, A. J., Alosaimy, S., Lucas, K., Schrack, M. R., Andrade, J., Herbin, S. R., Biagi, M., Pierce, M., Molina, K. C., Perkins, N. B., Cosimi, R., Kang-Birken, L., King, M. A., Pullinger, B. M., Rojas, L. M., Bouchard, J., Hobbs, A. L. V., Agee, J., ... Rybak, M. J. (Accepted/In press). Clinical Outcomes of Eravacycline in Patients Treated for Stenotrophomonas maltophilia Infections. Infectious Diseases and Therapy. https://doi.org/10.1007/s40121-025-01170-x

@article{855365f61abf4073b9aa79a3215cfc6d,

title = "Clinical Outcomes of Eravacycline in Patients Treated for Stenotrophomonas maltophilia Infections",

abstract = "Introduction: Stenotrophomonas maltophilia is notable for its rising incidence and multidrug resistance, which complicates treatment. As a result of insufficient clinical studies, the 2024 Infectious Diseases Society of America (IDSA) Guidance on Treating Antimicrobial Resistant Gram-negative Infection advises against using eravacycline (ERV) for S. maltophilia infections. We present real-world data on patients treated with ERV for these infections. Methods: This multicenter, retrospective, observational study included adult patients who received ERV for treating S. maltophilia infections for ≥ 72 h between October 2018 and August 2022. The primary outcome was the clinical cure evaluated at the end of ERV therapy. Key secondary outcomes included a 30-day survival rate, absence of infection recurrence counting from the end of ERV therapy, and occurrence of possible ERV-related adverse effects (AE) noted in the patient{\textquoteright}s records. Results: Overall, 41 patients were included with a median (interquartile range [IQR]) age of 63 years (46.0–74.5). Most patients were male (63.4\%) and white (51.2\%). The primary source of infection was pulmonary (56.1\%), and most patients received ERV for regimen consolidation (65.9\%). Combination therapy was used in about 10\% of the cases for S. maltophilia treatment. The median (IQR) duration of ERV treatment was 7 days (4.0–11.5). The clinical cure rate was 73.2\%, and the 30-day survival rate was 68.3\%. Four patients (9.8\%) experienced possible AE from ERV. Conclusion: S. maltophilia infections are challenging to treat because of limited options. An analysis of 41 patients indicates ERV may be an acceptable treatment option, but more clinical studies are needed to evaluate its efficacy and safety.",

keywords = "Antimicrobial resistance, Drug resistance, Eravacycline, Gram-negative, Stenotrophomonas maltophilia",

author = "\{Al Musawa\}, Mohammed and \{Kunz Coyne\}, \{Ashlan J.\} and Sara Alosaimy and Kristen Lucas and Schrack, \{Melanie Rae\} and Justin Andrade and Herbin, \{Shelbye R.\} and Mark Biagi and Michael Pierce and Molina, \{Kyle C.\} and Perkins, \{Nicholson B.\} and Reese Cosimi and Lena Kang-Birken and King, \{Madeline A.\} and Pullinger, \{Benjamin M.\} and Rojas, \{Leonor M.\} and Jeannette Bouchard and Hobbs, \{Athena L.V.\} and Jazmin Agee and Caniff, \{Kaylee E.\} and \{Van Helden\}, \{Sean R.\} and Veve, \{Michael P.\} and Rybak, \{Michael J.\}",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2025.",

year = "2025",

doi = "10.1007/s40121-025-01170-x",

language = "English",

journal = "Infectious Diseases and Therapy",

issn = "2193-8229",

publisher = "Springer Healthcare",

}

Al Musawa, M, Kunz Coyne, AJ, Alosaimy, S, Lucas, K, Schrack, MR, Andrade, J, Herbin, SR, Biagi, M, Pierce, M, Molina, KC, Perkins, NB, Cosimi, R, Kang-Birken, L, King, MA, Pullinger, BM, Rojas, LM, Bouchard, J, Hobbs, ALV, Agee, J, Caniff, KE, Van Helden, SR, Veve, MP & Rybak, MJ 2025, 'Clinical Outcomes of Eravacycline in Patients Treated for Stenotrophomonas maltophilia Infections', Infectious Diseases and Therapy. https://doi.org/10.1007/s40121-025-01170-x

TY - JOUR

T1 - Clinical Outcomes of Eravacycline in Patients Treated for Stenotrophomonas maltophilia Infections

AU - Al Musawa, Mohammed

AU - Kunz Coyne, Ashlan J.

AU - Alosaimy, Sara

AU - Lucas, Kristen

AU - Schrack, Melanie Rae

AU - Andrade, Justin

AU - Herbin, Shelbye R.

AU - Biagi, Mark

AU - Pierce, Michael

AU - Molina, Kyle C.

AU - Perkins, Nicholson B.

AU - Cosimi, Reese

AU - Kang-Birken, Lena

AU - King, Madeline A.

AU - Pullinger, Benjamin M.

AU - Rojas, Leonor M.

AU - Bouchard, Jeannette

AU - Hobbs, Athena L.V.

AU - Agee, Jazmin

AU - Caniff, Kaylee E.

AU - Van Helden, Sean R.

AU - Veve, Michael P.

AU - Rybak, Michael J.

PY - 2025

Y1 - 2025

N2 - Introduction: Stenotrophomonas maltophilia is notable for its rising incidence and multidrug resistance, which complicates treatment. As a result of insufficient clinical studies, the 2024 Infectious Diseases Society of America (IDSA) Guidance on Treating Antimicrobial Resistant Gram-negative Infection advises against using eravacycline (ERV) for S. maltophilia infections. We present real-world data on patients treated with ERV for these infections. Methods: This multicenter, retrospective, observational study included adult patients who received ERV for treating S. maltophilia infections for ≥ 72 h between October 2018 and August 2022. The primary outcome was the clinical cure evaluated at the end of ERV therapy. Key secondary outcomes included a 30-day survival rate, absence of infection recurrence counting from the end of ERV therapy, and occurrence of possible ERV-related adverse effects (AE) noted in the patient’s records. Results: Overall, 41 patients were included with a median (interquartile range [IQR]) age of 63 years (46.0–74.5). Most patients were male (63.4%) and white (51.2%). The primary source of infection was pulmonary (56.1%), and most patients received ERV for regimen consolidation (65.9%). Combination therapy was used in about 10% of the cases for S. maltophilia treatment. The median (IQR) duration of ERV treatment was 7 days (4.0–11.5). The clinical cure rate was 73.2%, and the 30-day survival rate was 68.3%. Four patients (9.8%) experienced possible AE from ERV. Conclusion: S. maltophilia infections are challenging to treat because of limited options. An analysis of 41 patients indicates ERV may be an acceptable treatment option, but more clinical studies are needed to evaluate its efficacy and safety.

AB - Introduction: Stenotrophomonas maltophilia is notable for its rising incidence and multidrug resistance, which complicates treatment. As a result of insufficient clinical studies, the 2024 Infectious Diseases Society of America (IDSA) Guidance on Treating Antimicrobial Resistant Gram-negative Infection advises against using eravacycline (ERV) for S. maltophilia infections. We present real-world data on patients treated with ERV for these infections. Methods: This multicenter, retrospective, observational study included adult patients who received ERV for treating S. maltophilia infections for ≥ 72 h between October 2018 and August 2022. The primary outcome was the clinical cure evaluated at the end of ERV therapy. Key secondary outcomes included a 30-day survival rate, absence of infection recurrence counting from the end of ERV therapy, and occurrence of possible ERV-related adverse effects (AE) noted in the patient’s records. Results: Overall, 41 patients were included with a median (interquartile range [IQR]) age of 63 years (46.0–74.5). Most patients were male (63.4%) and white (51.2%). The primary source of infection was pulmonary (56.1%), and most patients received ERV for regimen consolidation (65.9%). Combination therapy was used in about 10% of the cases for S. maltophilia treatment. The median (IQR) duration of ERV treatment was 7 days (4.0–11.5). The clinical cure rate was 73.2%, and the 30-day survival rate was 68.3%. Four patients (9.8%) experienced possible AE from ERV. Conclusion: S. maltophilia infections are challenging to treat because of limited options. An analysis of 41 patients indicates ERV may be an acceptable treatment option, but more clinical studies are needed to evaluate its efficacy and safety.

KW - Antimicrobial resistance

KW - Drug resistance

KW - Eravacycline

KW - Gram-negative

KW - Stenotrophomonas maltophilia

UR - http://www.scopus.com/inward/record.url?scp=105007333914&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=105007333914&partnerID=8YFLogxK

U2 - 10.1007/s40121-025-01170-x

DO - 10.1007/s40121-025-01170-x

M3 - Article

AN - SCOPUS:105007333914

SN - 2193-8229

JO - Infectious Diseases and Therapy

JF - Infectious Diseases and Therapy

ER -

Clinical Outcomes of Eravacycline in Patients Treated for Stenotrophomonas maltophilia Infections

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this