Intravesical VesiX as a Last Resort Therapy in Women With Antibiotic-Refractory Recurrent Urinary Tract Infections Contemplating Bladder Removal: A Preliminary Report.

This article focuses on the use of VesiX, a cetylpyridinium chloride (CPC)-based antimicrobial agent, administered via intravesical instillation to treat antibiotic-recalcitrant recurrent urinary tract infections (rUTI) in postmenopausal women. Under an FDA-approved expanded access protocol, three women with documented resistance or allergies to multiple antibiotic classes received VesiX after successful antibiotic courses, resulting in elimination of detectable bacteria in urine cultures for two patients, while one patient did not respond. In vitro testing confirmed VesiX's bactericidal activity against both Gram-negative and Gram-positive uropathogens isolated from these patients. The report suggests potential for VesiX as an alternative therapy in complex rUTI cases but emphasizes the need for further patient enrollment to clarify its clinical role.