Urinary antiseptic

Urinary antiseptics are drugs that exert their antimicrobial effect in the urine and are devoid of virtually any significant systemic effect. Prolonged use for prophylaxis and/or suppression is common in recurrent or chronic UTIs where other antimicrobials can be used only for short durations because they do not sustain sterility. 

Bacteriostatic drug. It is effective against a variety of gram positive and negative organisms including E. coli and Aerobacter. It is most commonly used as urinary antiseptic for prophylaxis and treatment of urinary tract infections. 

It is mainly used as urinary antiseptic and in diarrhoea caused by E. coli, Shigella, Salmonella. 

Urinary antiseptics are orally administered agents that exert antibacterial activity in the urine but have no systemic antibacterial activity. Urinary antiseptics are listed as in table 9.2.2. 

Methenamine mandelate is a salt of mandelic acid and methenamine and both of these possess property of urinary antiseptic. It is rapidly absorbed in gastrointestinal tract and excreted unchanged in urine, where it broken down in acidic pH (< 5) of urine and formaldehyde is released, which inhibits most of the bacteria. It is administered with sodium biphosphate, mandelic acid or ascorbic acid to keep the urinary pH below 6. Its use is restricted to chronic, resistant type of UTI. 

Pure hexamine may be taken internally by some persons in small amounts and it is used in medicine as a urinary antiseptic, but with some persons jt is toxic. It can also be a skin irritant... 

METRONIDAZOLE, MUPIROCIN, POLYMYXINS, URINARY ANTISEPTICS METRONIDAZOLE... 

Urinary antiseptics are oral agents that exert antibacterial activity in the urine but have little or no systemic antibacterial effect. Their usefulness is limited to lower urinary tract infections. Prolonged suppression of bacteriuria by means of urinary antiseptics may be desirable in chronic urinary tract infections in which eradication of infection by short-term systemic therapy has not been possible. 

Methenamine mandelate is the salt of mandelic acid and methenamine and possesses properties of both of these urinary antiseptics. Methenamine hippurate is the salt of hippuric acid and methenamine. Below pH 5.5, methenamine releases formaldehyde, which is antibacterial. Mandelic acid or hippuric acid taken orally is excreted unchanged in the urine, in which these drugs are bactericidal for some gram-negative bacteria when pH is less than 5.5. 

Methenamine mandelate, 1 g four times daily, or methen-amine hippurate, 1 g twice daily by mouth (children, 50 mg/kg/d or 30 mg/kg/d, respectively), is used only as a urinary antiseptic to suppress, not treat, urinary tract infection. Acidifying agents (eg, ascorbic acid, 4-12 g/d) may be given to lower urinary pH below 5.5. Sulfonamides should not be given at the same time because they may form an insoluble compound with the formaldehyde released by methenamine. Persons taking methenamine mandelate may exhibit falsely elevated tests for catecholamine metabolites. 

Piper cubeba L. Bi Cheng Qie (Cubeb, tailed pepper) (unripe fruit) Cubebin, dipentene, cadinene, cineol, carene, camphene, pinene, sabinene, azulene, terpineol.49 Urinary antiseptic, stomachic, carminative. 

Nitrofurantoin has been used as an urinary antiseptic in calves and horses at an oral dosage of 10 mg/kg bw/day. It is absorbed rapidly and completely from the gastrointestinal tract. About 40% of the drug is eliminated in the urine, while the remainder is catabolized. 

Hexamethylenetetramine (70) has been widely used as a urinary antiseptic under the names Methenamine or Urotropin (B-61MI22000, p. 712). The synthetic applications have already been discussed (see Section 2.20.3.14). 

Buchu is believed to possess urinary antiseptic and diuretic properties. It has been used for cystitis urethritis, prostatitis, and specifically to treat acute catarrhal cystitis. 

Celery is stated to possess antirheumatic, sedative, mild diuretic, and urinary antiseptic properties. It has been used for arthritis, rheumatism, gout, urinary tract inflammation, and specifically for rheumatoid arthritis with mental depression. 

Meadowsweet is reputed to have stomachic, mild urinary antiseptic, antirheumatic, astringent, and antacid properties. Traditionally, it has been used for atonic dyspepsia with heartburn and hyperacidity, acute catarrhal cystitis, rheumatic muscle and joint pains, diarrhea in children, and specifically for the prophylaxis and treatment of peptic ulcers. 

Saw palmetto is known to have diuretic, urinary antiseptic, endocrinological, and anabolic properties. Traditionally, it is used for chronic or subacute cystitis, catarrh of the genitourinary tract, testicular atrophy, sex hormone disorders, and specifically for prostatic enlargement. 

Yarrow possesses diaphoretic, antipyretic, hypotensive, astringent, diuretic, and urinary antiseptic properties. Traditionally, it has been used for fevers, common colds, essential hypertension, amenorrhea, dysentery, diarrhea, and specifically for thrombotic conditions with hypertension, including cerebral and coronary thromboses. 

Topical antibiotics with a narrow spectrum of action and low toxicity (eg, bacitracin and mupirocin) can be used for temporary control of bacterial growth and are generally preferred to antiseptics. Methenamine mandelate releases formaldehyde in a low antibacterial concentration at acid pH and can be an effective urinary antiseptic for long-term control of urinary tract infections. 

Hexamethylenediamine is used in the production of nylon 6,6 and mainly in making phenol-formaldehyde resins, where it is known as hexa. It is also used as a urinary antiseptic (Urotropine) as well as in the rubber industry and for the manufacture of the explosive cyclonite. 

Pharmaceutical Industry Disinfectant (formin, urotropin, crystazol, helmitol), urinary antiseptic... 

DOT CLASSIFICATION 4.1 Label Flammable Solid SAFETY PROFILE A poison by subcutaneous route. Moderately toxic by ingestion and intraperitoneal routes. Questionable carcinogen with experimental tumorigenic data. An irritant to skin, eyes, and mucous membranes. Some persons suffer a skin rash if they come in contact with this material or the fumes evolved when it is heated. Human mutation data reported. Pure hexamethylenetetramine may be taken internally in small amounts and has been used in medicine as a urinary antiseptic. Its major industrial use is in the manufacture of phenolic resins. 

Garrett JV, Hallum J, Scott P. Urinary antiseptics causing haemolytic anaemia in pregnancy in a West Indian woman with red cell enzyme deficiency. J Obstet Gynaecol Br Commonw 1963 70 1073-5. 

Mcthenamine is used internally as a urinary antiseptic for the treatment of chronic urinary tract infections. The free base has practically no hacteriostatic power formaldehyde relca.se at the lower pH of the kidney is required. To optimize the antibacterial effect, an acidifying agent. such as sodium biphusphatc or ammonium chloride generally accumpanies the administratiun of methenaminc. 

Phenazopyricline hydrochloride was formerly used as a urinary antiseptic. Although it isactivc in vitro again.st staph-yliK occi. streptococci, gonococci, and . coli. it has no useful antibacterial activity in the urine. Thus, its present utility lies in its local analgesic effect on the mucosa of the urinary tract. 

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