From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
For hospice patients with indwelling Foley catheters who develop urinary tract infections requiring treatment, the decision to treat should be guided by symptom management rather than sterilizing the urine, and antibiotics should only be used when the patient has symptoms causing discomfort like fever, pain, or agitation, with nitrofurantoin or trimethoprim-sulfamethoxazole being suitable options 1. When considering antibiotic treatment for hospice patients with catheter-associated UTIs, it's essential to prioritize symptom relief and comfort over complete microbiological cure.
- The goal of treatment in hospice care is to manage symptoms and improve the patient's quality of life, rather than to eradicate the infection completely.
- According to a study published in 2022, there is no significant difference in medication consumption between patients who receive antibiotics and those who do not, suggesting that antibiotics may not be necessary for terminal delirium management 2.
- The choice of antibiotic should be based on the patient's specific needs and medical history, with consideration given to oral options to minimize discomfort and promote ease of administration.
- Nitrofurantoin and trimethoprim-sulfamethoxazole are commonly recommended first-line antibiotics for UTIs in hospice patients, due to their effectiveness against common urinary pathogens and relatively mild side effect profiles 1.
- However, the use of antibiotics in hospice care should be approached with caution, and alternative strategies such as catheter changes should be considered for asymptomatic bacteriuria, which is nearly universal in long-term catheterized patients.
- Ultimately, the decision to treat a UTI in a hospice patient should be individualized and based on a thorough assessment of the patient's symptoms, medical history, and overall goals of care, with a focus on promoting comfort, dignity, and quality of life 3, 4.