Can a patient take Cimzia (certolizumab pegol) with a urinary tract infection (UTI) and about to start antibiotics?

From the Guidelines

It's generally recommended to temporarily pause Cimzia (certolizumab pegol) if you have an active urinary tract infection (UTI) and are starting antibiotics, as Cimzia is a TNF-alpha inhibitor that suppresses part of your immune system, which could potentially interfere with your body's ability to fight the infection effectively 1. You should contact your rheumatologist or prescribing physician before making any changes to your medication regimen. They may advise holding Cimzia until you've completed your antibiotic course and the infection has resolved, typically 3-7 days after finishing antibiotics.

Key Considerations

• The decision to pause Cimzia ultimately depends on the severity of your infection, your overall health status, and the specific condition being treated with Cimzia.
• Some physicians may allow continuing Cimzia during treatment of mild infections, while others prefer a more cautious approach.
• During this time, continue any other medications as prescribed unless otherwise directed by your healthcare provider.
• According to recent guidelines, short-course antibiotics may be sufficient for treating UTIs, with durations ranging from 5-14 days depending on the type of antibiotic and the severity of the infection 1.
• It's essential to follow the guidance of your healthcare provider and complete the full course of antibiotics as prescribed to ensure the infection is fully cleared.

Management of UTI

• Appropriate management of the urological abnormality or the underlying complicating factor is mandatory, as outlined in the European Association of Urology guidelines 1.
• Optimal antimicrobial therapy for complicated UTI depends on the severity of the illness at presentation, as well as local resistance patterns and specific host factors.
• A urine culture and susceptibility testing should be performed, and initial empiric therapy should be tailored and followed by (oral) administration of an appropriate antimicrobial agent for the uropathogen isolated.

From the FDA Drug Label

Patients treated with CIMZIA are at an increased risk for developing serious infections involving various organ systems and sites that may lead to hospitalization or death Treatment with CIMZIA should not be initiated in patients with an active infection, including clinically important localized infections.

The patient should not take Cimzia with an active Urinary Tract Infection (UTI) and about to start antibiotics, as the drug label states that treatment with Cimzia should not be initiated in patients with an active infection. 2

From the Research

Cimzia and UTI Treatment

• Cimzia (certolizumab pegol) is a medication used to treat various inflammatory conditions, but its interaction with urinary tract infections (UTIs) and antibiotics is not directly addressed in the provided studies.
• However, the treatment of UTIs with antibiotics is a common practice, and the provided studies discuss the diagnosis and management of UTIs 3, 4, 5, 6, 7.
• It is essential to note that patients with UTIs should be treated with antibiotics based on culture and sensitivity results to ensure effective treatment and reduce the risk of antibiotic resistance 4, 6.

Antibiotic Use and Cimzia

• There is no direct evidence in the provided studies that suggests Cimzia interacts with antibiotics used to treat UTIs.
• However, patients taking Cimzia should inform their healthcare provider about any underlying conditions, including UTIs, and any medications they are taking, including antibiotics.
• The decision to start antibiotics for a UTI should be based on the patient's clinical presentation, urine culture results, and medical history, rather than the use of Cimzia alone 3, 7.

Management of UTIs

• The management of UTIs involves the use of antibiotics, and the choice of antibiotic should be based on culture and sensitivity results 4, 5, 6.
• Patients with UTIs should be monitored for signs of improvement or worsening of symptoms, and antibiotic therapy should be adjusted accordingly.
• In some cases, alternative treatments, such as probiotics or antimicrobial peptides, may be considered, but more research is needed to determine their effectiveness 6.