{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:17:58Z","timestamp":1790713078693,"version":"4.1.0"},"reference-count":108,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,6,8]],"date-time":"2023-06-08T00:00:00Z","timestamp":1686182400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Stenotrophomonas maltophilia<\/jats:italic> is an opportunistic pathogen and frequent cause of serious nosocomial infections. Patient populations at greatest risk for these infections include the immunocompromised and those with chronic respiratory illnesses and prior antibiotic exposure, notably to carbapenems. Its complex virulence and resistance profile drastically limit available antibiotics, and incomplete breakpoint and pharmacokinetic\/pharmacodynamic (PK\/PD) data to inform dose optimization further complicates therapeutic approaches. Clinical comparison data of first\u2010line agents, including trimethoprim\u2010sulfamethoxazole (TMP\u2010SMX), quinolones, and minocycline, are limited to conflicting observational data with no clear benefit of a single agent or combination therapy. Newer antibiotic approaches, including cefiderocol and aztreonam\u2010 avibactam, are promising alternatives for extensively drug\u2010resistant isolates; however, clinical outcomes data are needed. The potential clinical utility of bacteriophage for compassionate use in treating <jats:italic>S. maltophilia<\/jats:italic> infections remains to be determined since data is limited to in\u2010vitro and sparse in\u2010vivo work. This article provides a review of available literature for <jats:italic>S.\u2009maltophilia<\/jats:italic> infection management focused on related epidemiology, resistance mechanisms, identification, susceptibility testing, antimicrobial PK\/PD, and emerging therapeutic strategies.<\/jats:p>","DOI":"10.1002\/phar.2828","type":"journal-article","created":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T04:04:40Z","timestamp":1684382680000},"page":"833-846","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Steno\u2010sphere: Navigating the enigmatic world of emerging <scp>multidrug\u2010resistant<\/scp><i>Stenotrophomonas maltophilia<\/i>"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4891-8625","authenticated-orcid":false,"given":"Ashlan J.","family":"Kunz\u00a0Coyne","sequence":"first","affiliation":[{"name":"Anti\u2010Infective Research Laboratory College of Pharmacy and Health Sciences, Wayne State University  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4480-6159","authenticated-orcid":false,"given":"Shelbye","family":"Herbin","sequence":"additional","affiliation":[{"name":"Henry Ford Wyandotte  Wyandotte Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1468-8267","authenticated-orcid":false,"given":"Kaylee","family":"Caniff","sequence":"additional","affiliation":[{"name":"Anti\u2010Infective Research Laboratory College of Pharmacy and Health Sciences, Wayne State University  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2220-0081","authenticated-orcid":false,"given":"Michael J.","family":"Rybak","sequence":"additional","affiliation":[{"name":"Anti\u2010Infective Research Laboratory College of Pharmacy and Health Sciences, Wayne State University  Detroit Michigan USA"},{"name":"School of Medicine Wayne State University  Detroit Michigan USA"},{"name":"Department of Pharmacy Services Detroit Receiving Hospital  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,8]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1099\/00221287-26-1-123"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1099\/00207713-43-3-606"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1099\/00207713-33-2-409"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1586\/14787210.2014.864553"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa141"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12866-020-01985-3"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/diseases7020041"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/23744235.2018.1531145"},{"key":"e_1_2_4_10_1","doi-asserted-by":"crossref","unstructured":"Gajd\u00e1csM Urb\u00e1nE.Prevalence and Antibiotic Resistance ofStenotrophomonas maltophiliain Respiratory Tract Samples: a 10\u2010Year Epidemiological Snapshot.2019. Accessed November 15 2022;6. doi:10.1177\/2333392819870774","DOI":"10.1177\/2333392819870774"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.2174\/1874285801307010118"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijmr.IJMR_1105_15"},{"key":"e_1_2_4_13_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00793-21"},{"key":"e_1_2_4_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.16477"},{"key":"e_1_2_4_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-009-0709-5"},{"key":"e_1_2_4_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0037375"},{"key":"e_1_2_4_17_1","doi-asserted-by":"publisher","DOI":"10.1592\/phco.31.4.338"},{"key":"e_1_2_4_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofab644"},{"key":"e_1_2_4_19_1","doi-asserted-by":"publisher","DOI":"10.2217\/fmb.09.84"},{"key":"e_1_2_4_20_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2015.00893"},{"key":"e_1_2_4_21_1","doi-asserted-by":"crossref","unstructured":"NagZ\u2010Dependent and NagZ\u2010Independent Mechanisms for \u03b2\u2010Lactamase Expression inStenotrophomonas maltophilia| Antimicrobial Agents and Chemotherapy. Accessed November 16 2022. 56 1936 1941. doi:10.1128\/AAC.05645-11","DOI":"10.1128\/AAC.05645-11"},{"key":"e_1_2_4_22_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01446-13"},{"key":"e_1_2_4_23_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.03354-14"},{"key":"e_1_2_4_24_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00795-06"},{"key":"e_1_2_4_25_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.16.3.430-450.2003"},{"key":"e_1_2_4_26_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00554-18"},{"key":"e_1_2_4_27_1","unstructured":"Frontiers | Phenotypic Heterogeneity AffectsStenotrophomonas maltophiliaK279a Colony Morphotypes and \u03b2\u2010Lactamase Expression. Accessed November 15 2022. doi:10.3389\/fmicb.2015.01373\/full"},{"key":"e_1_2_4_28_1","doi-asserted-by":"publisher","DOI":"10.1021\/acs.chemrev.1c00055"},{"key":"e_1_2_4_29_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00317-11"},{"key":"e_1_2_4_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/gbe\/evv161"},{"key":"e_1_2_4_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-41308-9"},{"key":"e_1_2_4_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky024"},{"key":"e_1_2_4_33_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2019.00822"},{"key":"e_1_2_4_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-88977-z"},{"key":"e_1_2_4_35_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0157693"},{"key":"e_1_2_4_36_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00714-15"},{"key":"e_1_2_4_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2009.09.015"},{"key":"e_1_2_4_38_1","doi-asserted-by":"publisher","DOI":"10.1080\/14787210.2019.1685875"},{"key":"e_1_2_4_39_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1462-5822.2003.00306.x"},{"key":"e_1_2_4_40_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2020.01160"},{"key":"e_1_2_4_41_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics11020250"},{"key":"e_1_2_4_42_1","unstructured":"EM100 Connect \u2013 CLSI M100 ED32:2022. Accessed June 21 2022.http:\/\/em100.edaptivedocs.net\/GetDoc.aspx?doc=CLSI%20M100%20ED32:2022&xormat=SPDF&src=BB"},{"key":"e_1_2_4_43_1","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlac040"},{"key":"e_1_2_4_44_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02631-20"},{"key":"e_1_2_4_45_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00654-21"},{"key":"e_1_2_4_46_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy293"},{"key":"e_1_2_4_47_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab1013"},{"key":"e_1_2_4_48_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/22.3.508"},{"key":"e_1_2_4_49_1","doi-asserted-by":"publisher","DOI":"10.1128\/aac.02167-21"},{"key":"e_1_2_4_50_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkac304"},{"key":"e_1_2_4_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2004.09.002"},{"key":"e_1_2_4_52_1","doi-asserted-by":"publisher","DOI":"10.18773\/austprescr.2021.035"},{"key":"e_1_2_4_53_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01154-19"},{"key":"e_1_2_4_54_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0156690"},{"key":"e_1_2_4_55_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkab344"},{"key":"e_1_2_4_56_1","unstructured":"Advances in the Microbiology ofStenotrophomonas maltophilia\u2013 PubMed. Accessed November 29 2022.https:\/\/pubmed.ncbi.nlm.nih.gov\/34043457\/"},{"key":"e_1_2_4_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2021.106367"},{"key":"e_1_2_4_58_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01934-17"},{"key":"e_1_2_4_59_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkac018"},{"key":"e_1_2_4_60_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky279"},{"key":"e_1_2_4_61_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01699-19"},{"key":"e_1_2_4_62_1","unstructured":"Antimicrobial activity of tigecycline and cefoperazone\/sulbactam tested against 18 386 Gram\u2010negative organisms from Europe and the Asia\u2010Pacific region (2013\u20132014) \u2013 ClinicalKey. Accessed December 1 2022.https:\/\/www.clinicalkey.com\/#!\/content\/playContent\/1\u2010s2.0\u2010S0732889317300767?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0732889317300767%3Fshowall%3Dtrue&referrer="},{"key":"e_1_2_4_63_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2013.02.009"},{"key":"e_1_2_4_64_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2017.12.013"},{"key":"e_1_2_4_65_1","doi-asserted-by":"publisher","DOI":"10.3109\/23744235.2015.1064542"},{"key":"e_1_2_4_66_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613-020-00715-2"},{"key":"e_1_2_4_67_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz394"},{"key":"e_1_2_4_68_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01603-19"},{"key":"e_1_2_4_69_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01485-07"},{"key":"e_1_2_4_70_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa008"},{"key":"e_1_2_4_71_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00678-12"},{"key":"e_1_2_4_72_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac095"},{"key":"e_1_2_4_73_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2022.02.001"},{"key":"e_1_2_4_74_1","doi-asserted-by":"publisher","DOI":"10.1128\/aac.01801-18"},{"key":"e_1_2_4_75_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01990-21"},{"key":"e_1_2_4_76_1","doi-asserted-by":"publisher","DOI":"10.1093\/jacamr\/dlac011"},{"key":"e_1_2_4_77_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00297-20"},{"key":"e_1_2_4_78_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00777-17"},{"key":"e_1_2_4_79_1","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.00405-19"},{"key":"e_1_2_4_80_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkaa197"},{"key":"e_1_2_4_81_1","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0000000000000857"},{"key":"e_1_2_4_82_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2014.01.007"},{"key":"e_1_2_4_83_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2014.04.004"},{"key":"e_1_2_4_84_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2014.10.009"},{"key":"e_1_2_4_85_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2018.02871"},{"key":"e_1_2_4_86_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq131"},{"key":"e_1_2_4_87_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2209"},{"key":"e_1_2_4_88_1","doi-asserted-by":"crossref","unstructured":"Full article: A historical overview of bacteriophage therapy as an alternative to antibiotics for the treatment of bacterial pathogens. Accessed December 19 2022. doi:10.4161\/viru.25991","DOI":"10.4161\/viru.25991"},{"key":"e_1_2_4_89_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2358"},{"key":"e_1_2_4_90_1","doi-asserted-by":"publisher","DOI":"10.3390\/v13061057"},{"key":"e_1_2_4_91_1","doi-asserted-by":"publisher","DOI":"10.1128\/aac.02071-21"},{"key":"e_1_2_4_92_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2020.07.014"},{"key":"e_1_2_4_93_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa389"},{"key":"e_1_2_4_94_1","doi-asserted-by":"publisher","DOI":"10.3390\/pharmaceutics14102216"},{"key":"e_1_2_4_95_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2018.11.008"},{"key":"e_1_2_4_96_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01682-13"},{"key":"e_1_2_4_97_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01324-13"},{"key":"e_1_2_4_98_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00788-19"},{"key":"e_1_2_4_99_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkv456"},{"key":"e_1_2_4_100_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkw327"},{"key":"e_1_2_4_101_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121-021-00516-5"},{"key":"e_1_2_4_102_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofy210.2072"},{"key":"e_1_2_4_103_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30554-1"},{"key":"e_1_2_4_104_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30796-9"},{"key":"e_1_2_4_105_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30731-3"},{"key":"e_1_2_4_106_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-022-05006-3"},{"key":"e_1_2_4_107_1","doi-asserted-by":"crossref","unstructured":"Successful Treatment of Bloodstream Infection Due to Metallo\u2010\u03b2\u2010Lactamase\u2010ProducingStenotrophomonas maltophiliain a Renal Transplant Patient. | Antimicrobial Agents and Chemotherapy. Accessed February 27 2023. doi:10.1128\/AAC.00264-16","DOI":"10.1128\/AAC.00264-16"},{"key":"e_1_2_4_108_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa439.1787"},{"key":"e_1_2_4_109_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2013.01.020"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.2828","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T12:33:43Z","timestamp":1761050023000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.2828"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,8]]},"references-count":108,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1002\/phar.2828"],"URL":"https:\/\/doi.org\/10.1002\/phar.2828","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,8]]},"assertion":[{"value":"2022-12-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}