A Randomized Double-Blind Study of Acetohydroxamic Acid in Struvite Nephrolithiasis

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Abstract
We studied the effects of the bacterial urease inhibitor acetohydroxamic acid on the growth of struvite stones in the urinary tract. Eighteen patients who received acetohydroxamic acid (15 mg per kilogram of body weight per day, in divided oral doses) for a mean of 15.8 months were compared in a randomized double-blind study with 19 patients who received placebo for a mean of 19.6 months. Seven patients given placebo reached a predetermined end point: a 100 per cent increase in the two-dimensional surface area of their stones. No patient who received acetohydroxamic acid had a doubling of stone size (P<0.01). Nine patients receiving the drug and one patient receiving placebo required a decrease in dosage or cessation of treatment because of adverse effects (P<0.01). Episodes of tremulousness (n=5, P<0.05), which reversed with a decrease in drug dose, and phlebothrombosis (n=3, P not significant) were limited to the group given acetohydroxamic acid.