acetohydroxamic acid (Lithostat)
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Introduction
Tradename: Lithostat.
Indications
- treatment of bacterial infections due to susceptible bacteria
- adjunctive therapy in chronic urea-splitting urinary tract infection (UTI), such as that caused by Proteus spp.
- treatment of struvite renal calculi[2]
Dosage
250 mg PO TID-QID, max dose 1.5 g
Dosage adjustment in renal failure
Table
| serum creatinine | max daily dose |
|---|---|
| < 1.4 mg/dL | 1.5 g |
| 1.4-1.8 mg/dL | 1.0 g |
| > 2.0 mg/dL | 0.5 g |
Pharmacokinetics
- well absorbed orally
- 35-70% eliminated unchanged in the urine
elimination via kidney
1/2life = 5-10 hours
Adverse effects
- headache
- depression
- anxiety
- nausea
- anorexia
- lethargy
- reticulocytosis
- phlebitis in the legs
- deep venous thrombosis (DVT)
- rash
- hemolysis
Drug interactions
- heavy metals: chelates all heavy metals including iron, leading to diminished absorption
- alcohol: combination increases incidence of rash
Mechanism of action
- reversibly inhibits bacterial urease
- reduction of ammonia production in the urine
- reduction of pH which enhances activity of antimicrobial agents