Gleckman R, Alvarez S, Joubert D W, Matthews S J
Am J Hosp Pharm. 1979 Nov;36(11):1509-12.
The mechanism of action, spectrum of antimicrobial activity, pharmacokinetics, adverse effects, therapeutic use, and dosage of methenamine hippurate and methenamine mandelate are reviewed. The antimicrobial activity of methenamine depends on its conversion in the urine to formaldehyde. Formaldehyde's spectrum of antibacterial activity encompasses all urinary tract pathogens. Urinary concentrations of formaldehyde vary with pH and urine volume; however, there is no documentation that acdification of the urine enhances methenamine's therapeutic activity. Adverse reactions to methenamine, including gastrointestinal intolerance and skin reactions, are mild and reversible and occur infrequently. Methenamine mandelate and hippurate are effective in the prevention of recurrent urinary tract infections except in patients with Foley catheters or who require intermittent catheterization.
对马尿酸乌洛托品和扁桃酸乌洛托品的作用机制、抗菌活性谱、药代动力学、不良反应、治疗用途及剂量进行了综述。乌洛托品的抗菌活性取决于其在尿液中转化为甲醛。甲醛的抗菌活性谱涵盖所有尿路病原体。尿液中甲醛的浓度随pH值和尿量而变化；然而，没有文献证明尿液酸化可增强乌洛托品的治疗活性。乌洛托品的不良反应，包括胃肠道不耐受和皮肤反应，轻微且可逆，很少发生。除了使用弗利氏导管或需要间歇性导尿的患者外，扁桃酸乌洛托品和马尿酸乌洛托品对预防复发性尿路感染有效。
