1. CASE Information:
  • 62-year-old male with neurogenic bladder who intermittently straight catheterizes himself has experienced at least three UTIs within the last 9 months
  • Urinary cultures have been positive for E. coli
  • He presents to the emergency department after being found febrile and generally ill appearing at his skilled nursing facility

What would be your approach in selecting therapy for this patient?

2. CASE Information:
  • 67-year-old woman, returned from Mexico where she was hospitalized for a COPD exacerbation, diagnosed with ventilator-associated pneumonia, and received 14 days of meropenem and ciprofloxacin
  • Hospitalized again due to worsening difficulty breathing with fever
  • Diagnosed with pneumonia, started on cefepime and azithromycin
  • Sputum cultures reveal numerous Gram-negative rods, subsequently identified as P. aeruginosa. She is not improving clinically, is intubated, and moved to ICU
  • Susceptibilities return for P. aeruginosa as R to cefepime, ceftazidime, piperacillin-tazobactam, meropenem, and ciprofloxacin

Which approach for this patient may have more activity against P. aeruginosa?

3. Additional susceptibilities return for this 67-year old woman with VAP, and P. aeruginosa is susceptible to ceftolozane-tazobactam and ceftazidime-avibactam. After consultation, it is determined that ceftolozane-tazobactam will be initiated. At what dose would you use?

4. A combination of imipenem and which of the following agents is under investigation as an approach to imipenem-resistant P. aeruginosa?

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