Intra-Vesical Colistin for Pseudomonas aeruginosa Urinary Tract Infections

The numbers of multiple drug-resistant Gram-negative bacterial infections are rising worldwide. The threat is increased by the lack of new antibiotics, so clinicians are turning to older drugs previously abandoned due to their recognized toxicity, such as colistin. However, the need to avoid kidney toxicity from colistin has led to its topical use. We present the case of a patient with type I cardiorenal syndrome with cystitis due to multiple drug-resistant Pseudomonas aeruginosa who was successfully treated with intravesical instillation of colistin.

The case report is one of the few in the literature on the intravesical instillation of colistin to address lower urinary tract infection.Isolated intravesical colistin instillation was effective in a patient with anuria.