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P-778. Evaluation of Fluoroquinolone Use for Pseudomonal Urinary Tract Infections

Ludmila Nicov, Madiha Shah, Shu Li Lu, Kendra Salangsang, Hien Nguyen

Open Forum Infectious Diseases, 2026

310 participants

Abstract

Abstract Background Pseudomonas aeruginosa (PsAr) is responsible for roughly 10% of catheter-associated UTIs (CAUTIs) and up to 16% of ICU infections, often leading to complications such as bacteremia. Fluoroquinolones (FQs) remain one of the few oral treatment options for PsAr UTIs. Despite rising resistance, FQs like ciprofloxacin and levofloxacin achieve high urinary concentrations—potentially overcoming higher MICs and maintaining efficacy. In 2019, the CLSI lowered PsAr FQ breakpoints, raising questions about continued clinical effectiveness for higher MICs. This study aims to evaluate the use of FQs for treating pseudomonal UTIs and to assess clinical success in relation to MIC levels.Table 1.Baseline CharacteristicsTables 2 & 3.Primary Endpoint* Further breakdown of MIC not available Methods This retrospective observational study analyzed adult patients treated with FQ for a PsAr UTI between January 1, 2017, and December 31, 2022. Inclusion criteria were a positive urine culture for PsAr and treatment with ciprofloxacin or levofloxacin. Patients with prostatitis were excluded. The primary outcome was clinical cure within 7 days post-therapy. Secondary outcomes included relapse or reinfection within 30 days, with evaluation of risk factors such as indwelling urinary devices and history of kidney stones.Tables 4 & 5.Secondary Endpoint* Further breakdown of MIC not available Results Of 310 patients, 85 (27.4%) received levofloxacin and 225 (72.6%) received ciprofloxacin.…

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