From the Guidelines
Deflection is not a treatment for pseudomonas urinary tract infections (UTIs). For pseudomonas UTIs, appropriate antibiotics are required, and according to the most recent guidelines, novel β-lactam agents such as ceftolozane/tazobactam and ceftazidime/avibactam are currently the first-line options for targeted treatment 1. The choice of treatment depends on antibiotic susceptibility testing, as Pseudomonas aeruginosa often has resistance patterns.
Treatment Options
- For complicated urinary tract infections, a treatment course of 5-10 days is suggested, and for hospital-acquired or ventilator-associated pneumonia and bloodstream infection, a treatment course of 10-14 days is suggested 1.
- Colistin-based therapy, imipenem/cilastatin–relebactam, and cefiderocol might be potential alternatives for difficult-to-treat Pseudomonas aeruginosa (DTR-PA) infections 1.
- Anti-pseudomonal penicillins or cephalosporins combined with aminoglycosides may be considered when the antimicrobial susceptibility testing results are interpreted as susceptible 1.
Important Considerations
- Adequate hydration is important during treatment, and follow-up urine cultures are recommended to confirm eradication of the infection.
- Pseudomonas UTIs are often healthcare-associated and may require longer treatment courses than typical UTIs.
- If "deflection" was meant to refer to a specific medication or procedure, it is not a recognized standard treatment for pseudomonas infections in medical practice.
From the FDA Drug Label
1.7 Complicated and Recurrent Urinary Tract Infections Tobramycin for Injection is indicated for the treatment of complicated urinary tract infections caused by susceptible isolates of P. aeruginosa, Proteus spp., (indole-positive and indole-negative), E. coli, Klebsiella spp., Enterobacter spp., Serratia spp., S. aureus, Providencia spp., and Citrobacter spp. in adult and pediatric patients
- 10 Complicated Urinary Tract Infections: 10 Day Treatment Regimen Levofloxacin tablets are indicated for the treatment of complicated urinary tract infections (mild to moderate) due to Enterococcus faecalis, Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, or Pseudomonas aeruginosa
Tobramycin and levofloxacin can be used to treat Pseudomonas aeruginosa urinary tract infections (UTIs).
- Tobramycin is indicated for the treatment of complicated UTIs caused by P. aeruginosa.
- Levofloxacin is indicated for the treatment of complicated UTIs caused by P. aeruginosa. 2 3
From the Research
Treatment of Pseudomonas aeruginosa Urinary Tract Infections
- The provided studies do not directly address the use of deflection to treat Pseudomonas aeruginosa urinary tract infections (UTIs) 4, 5, 6, 7.
- However, studies have investigated the efficacy of various antibiotics against Pseudomonas aeruginosa infections, including UTIs 8.
- A study on the efficacy of fosfomycin against Pseudomonas aeruginosa UTIs in a dynamic in vitro bladder infection model found that simulated treatment with oral fosfomycin was ineffective, despite high urinary concentrations and repeated daily doses for 7 days 8.
- The study also found that emergence of resistance was observed in the majority of isolates and worsened following prolonged therapy 8.
- Other studies have discussed the challenges of treating Pseudomonas aeruginosa infections due to limited antibiotic options and emerging resistance 5, 6.
- The choice of antibiotic treatment for Pseudomonas aeruginosa infections depends on various factors, including the site of infection, patient risk factors, and local epidemiology 5, 6.
Antibiotic Treatment Options
- Ceftazidime, carbapenems, and piperacillin-tazobactam are commonly used antibiotics for treating Pseudomonas aeruginosa infections 4.
- Newer antibiotics, such as cefiderocol and imipenem-cilastatin-relebactam, have shown promising results against Pseudomonas aeruginosa 5, 6.
- However, the effectiveness of these antibiotics can vary depending on the specific strain of Pseudomonas aeruginosa and the presence of resistance mechanisms 6, 7.
Limitations of Current Evidence
- The provided studies have limitations, including the lack of direct evidence on the use of deflection to treat Pseudomonas aeruginosa UTIs 4, 5, 6, 7.
- Additionally, the studies on antibiotic treatment options have limitations, such as the variability in patient populations and infection types 4, 5, 6, 7.