UTI, Taken Faropenem, Done Urine Culture, History Of Interstitial Lung Disease, Bacteria In Culture. Aztreonam Advisable?

Question: XXXXXXX XXXXXXX F/70, Case of recurrent UTI. (Post void is normal)

Prexisting Interstitial Lung Disease with 24x7 Oxygen.

Latest Bacteria: E.Coli ESBL found in Urine Culture

Bacteria is sensitive to: AMIKACIN 24mm (but since this has been given earlier, not advised by UROLOGIST), AZTREONAM 23 mm, COTRIMOXAZOLE 24mm, IMIPENEM 23mm, MEROPENEM 23mm

She is being administered Faropenem Sodium ER 300mg BD since yesterday night.

Urologist has also advised AZOM (Azteronam Injection) 500mg TDS since ..but not administerd as the leaftet of drug manufacturer states:

DOSAGE and ADMINISTRATION: Certain antibiotic (eg. Cefoxitin, imipenem) may induce high levels of beta - lactamase in vitro in some gram-negative
aerobes such as Enterobacter and pseudonomas species, resulting in antagonism to many beta-lactam antibiotics including AZTREONAM. These in vitro findings suggest that such betalactamase inducing antibiotics not be used concurrently with aztreonam.

Case history:

Interstital Lung Disease Patient with

Recurrent UTI with significant post void (110ml) ...later Sonography showed insignificant post void

History of Bacteria found List (in culture) : E.Coli, Pseudonomas Aeruginosa, now E.Coli ESBL

UTI found on XXXXXXX 26, 2011, admitted in Hospital.

Antibiotics administered: (History wise)

IV: Magnex, Loxof, Fixra, Amikacin

Oral: Loxof 500, cefuroxime axetil, prulifloxacin


ADVISE REQUIRED for concurrent therapy of Azteronam Inj. Concurrent Therapy with faropenem Oral. Can we give the Azteronam / else what is to be done?

You have advised ertapenam. However she is taking Faropenem Sodium ER 300mg BD since 6/9/2011 evening. It has been advised by UROLOGIST to be taken for 6 days. Should we continue the Faropenem Sodium ER 300 mg BD and start ertapenam also, please advise ?

What is the name of exact ertapenam medicine (and mg) to be started and for upto how long it should be taken?

Urodynamic study cannot be undertaken as the patient is on 24x7 oxygen and is mostly bedridden. However we can and have got a Sonography done, which showed the pre void as 50cc and post void as NIL;