How to manage MDR Pseudomonas in Crohn’s patient?

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I understand your concern.

The presence of multi-drug resistant (MDR) pseudomonas infection in the urine of a Crohn's disease patient who is already on tablets of Azathioprine and Mesalamine requires prompt attention and management. Here are some steps that can be taken:

1. Consult with an infectious disease specialist to guide antibiotic selection and management of the infection.
2. Consider hospitalization for intravenous antibiotics if the patient is experiencing severe symptoms or the infection is not responding to oral antibiotics.
3. Evaluate the patient's immunosuppressive medication regimen, as some may need to be temporarily discontinued or dose-adjusted to prevent further immune compromise.
4. Consider long-term antibiotic prophylaxis to prevent recurrent infections in the patient.
5. Monitor the patient closely for signs of worsening infection or antibiotic toxicity.
6. Overall, the management of MDR Pseudomonas in a Crohn's disease patient requires a multidisciplinary approach involving infectious disease specialists and gastroenterologists.
7. You might need injectable Polymyxin B depending upon your creatinine clearance (CRCL). If you are catheterized, change the catheter.

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