Do you give chronic antibiotic prophylaxis for recurrent UTIs, including Pseudomonas aeruginosa, in a patient with retained ureteral stents?
Answer from: at Community Practice
If the "recurrent UTIs" are symptomatic (fever is what I would be mostly concerned about), then the stents should be changed as feasible, (I assume this has been done) and the UTIs treated as appropriate. If the UTIs continue after the change, I would just try to treat the symptomatic events as best...
I would not recommend chronic antibiotic suppression in the absence of symptoms, but do use pre-procedure antibiotics even in the absence of symptoms at the time of stent change, as we frequently see post-procedure sepsis-like syndrome in this setting.
This question comes up often too. I would also not prolong antibiotic durations because of retained stents. The goal of antibiotic treatment is to resolve the infection, not eliminate the bacteria.
I'm not aware of data on methenamine in patients with retained stents and recurrent UTIs, but I...
I will occasionally put someone on “suppression” if they complete therapy for a (UTI) with a retained stent with multiple episodes, and they are going to have the stent replaced soon (within the next few weeks to bridge them to stent replacement). I would not go longer than that.