What question did this study set out to answer?

This research aims to evaluate fluoroquinolone use for treating pseudomonal urinary tract infections and assess clinical success related to MIC levels.

January 14, 2026Open Access

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

Key Points

This research aims to evaluate fluoroquinolone use for treating pseudomonal urinary tract infections and assess clinical success related to MIC levels.
Retrospective observational study of adult patients treated with fluoroquinolones for Pseudomonas aeruginosa UTI.
Inclusion criteria included a positive urine culture for Pseudomonas aeruginosa and treatment with ciprofloxacin or levofloxacin.
Outcomes measured were clinical cure within 7 days, and relapse or reinfection within 30 days.
Clinical cure within 7 days was achieved in 82% of levofloxacin patients and 91% of ciprofloxacin patients.
All patients resistant to levofloxacin or intermediate/resistant to ciprofloxacin achieved clinical cure.
Recurrence within 30 days was 9% for levofloxacin and 12% for ciprofloxacin.

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 all recurrent cases remained susceptible to their respective fluoroquinolone. Among those with recurrence, 5 (62.5%) in the levofloxacin group and 18 (60%) in the ciprofloxacin group had indwelling catheters. No patients had a documented history of kidney stones by provider notes or imaging. Conclusion FQs remain a primary oral treatment option for pseudomonal UTIs and may achieve clinical cure despite higher MICs. Further research is needed to determine if high urinary FQ concentrations improve outcomes against intermediate or resistant PsAr isolates. Disclosures All Authors: No reported disclosures

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