Do you treat Stenotrophomonas maltophilia bacteremia with combination therapy and if so, what is your preferred combination of antibacterials?

Yes, I would use two agents, at least up front, as recommended in the 2024 IDSA guidelines (Tamma et al, PMID 39108079). The guidelines suggest two of the following agents should be used, unless the combination of ceftazidime-avibactam plus aztreonam is used instead: cefiderocol, TMP/SMX, levofloxac...

Yes – in the form of trimethoprim-sulfamethoxazole. I do not use additional drugs with it – so no. Trimethoprim-sulfa is almost always active and has a great deal of experience and literature to support its use. If it cannot be used a number of other choices have been suggested such as levofloxacin,...

A very recent (April 2026) retrospective analysis of 292 patients with S. maltophilia bacteremia, only 37 of whom received combination therapy (CT), reported a 10.8% mortality with CT and 25.9% (P=0.045) with monotherapy. At the same time, there was no significant difference in clinical response, in...