Drug therapy reviews: Oxolinic acid

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Abstract
The mechanism of action, spectrum of activity, pharmacokinetics, dosage, adverse reactions and therapeutic use of oxolinic acid, a synthetic antimicrobial agent used in treatment of bacte- rial urinary tract infections, are reviewed. The usual adult dose for treatment of an established urinary tract infection is 750 mg twice daily. After oral administration, oxolinic acid is absorbed rapidly from the gastrointestinal tract. Peak serum concentrations of the unconjugated drug are reached in two to four hours. A two-phase elimination pattern has been observed in humans after repeated dosing. Adverse reactions are experienced by 10 to 45% of patients receiving oxolinic acid. Most common adverse reactions are central nervous system toxicity (restlessness, dizziness, headache, drowsiness and visual disturbances) and gastrointestinal reactions (nausea, vomiting, abdominal discomfort and diarrhea). Oxolinic acid is an alternative form of therapy for the penicillin-sensitive, cephalosporinsensitive, or sulfonamide-sensitive adult with recurrent urinary tract infection caused by susceptible Escherichia coli and Proteus mirabilis tbat is not complicated by bacteremia. Oxolinic acid should not be prescribed for patients with acute symptomatic urinary tract infection, patierits experiencing bacteremia, pregnant women pr children.

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