Clinical outcomes of Eravacycline in patients with Stenotrophomonas maltophilia infections: a multicentre observational study in China

As clinical evidence evaluating eravacycline (ERV) against Stenotrophomonas maltophilia remains limited worldwide, this real-world study aims to evaluate the effectiveness of ERV for treating S. maltophilia infections in China. This multicentre, retrospective, observational study analysed 103 adult patients treated with ERV (≥ 72 h) for S. maltophilia infections from August 2023 to August 2024. Primary outcomes were overall clinical effectiveness at the end of treatment (EOT) and 30 days post-EOT. Secondary outcomes included patient prognosis, microbiological efficacy and adverse events (AEs). The overall clinical effectiveness rate was 90.3% (93/103) at EOT and 88.3% (91/103) 30 days post-EOT, with 88.3% (91/103) of patients showing clinical improvement upon discharge. Among patients, isolated pneumonia was the most common presentation (71/103, 68.9%), followed by pneumonia with concomitant infection (21/103, 20.4%) and isolated extrapulmonary infection (11/103, 10.7%). At EOT, clinical effectiveness rates were 87.3% (62/71) for isolated pneumonia, 95.2% (20/21) for pneumonia with concomitant infection and 90.9% (10/11) for isolated extrapulmonary infection; by day 30 post-EOT, these rates remained stable across the respective subgroups. Among 61 patients with evaluable follow-up cultures, S. maltophilia clearance was 93.4% (57/61). Adverse events were minimal (3/103, 2.9%) and not severe. In this real-world study, ERV-containing regimens showed favourable clinical outcomes in S. maltophilia infections. While ERV represents a potential alternative or salvage option, the observed effectiveness must be interpreted cautiously due to baseline selection bias.