How Do Adjunct Antimicrobials Work?

Adjunct antimicrobials are given as a secondary treatment along with an ongoing primary treatment to treat chronic urinary tract infection, especially if it is a urea-splitting urinary infection.

Acetohydroxamic acid is a synthetic drug belonging to this class. Acetohydroxamic acid acts as an antagonist, inhibiting the bacterial enzyme urease present in the urine and decreasing ammonia production. Acetohydroxamic acid does not have any effect on the bacteria and it does not acidify urine.

Taurolidine/citrate/heparin catheter lock solution is yet to be approved by the U.S. Food and Drug Administration (FDA) for prevention of catheter-related bloodstream infections in patients with end-stage renal disease receiving hemodialysis through a central venous catheter.

Taurolidine is an amino acid with broad antimicrobial activity against gram-positive and gram-negative bacteria and mycobacteria and possesses antifungal activity to prevent infections in catheters. Taurolidine reacts with the bacterial cell wall and breaks the cell wall. It also neutralizes the bacterial endotoxins. 

Citrate has anticoagulation characteristics and works by chelating ionized calcium, which is a cofactor in the clotting cascade and finally stabilizes the process of coagulation.

Heparin is an anticoagulant and when given in low doses heparin inactivates factor Xa essential for the conversion of prothrombin to thrombin, and thus, blood clots are not formed.

Adjunct antimicrobials are used to treat chronic urinary tract infection.

Side effects associated with adjunct antimicrobials may include:

• Headache
• Nausea and vomiting
• Anorexia (an eating disorder characterized by loss of appetite)
• Felling of discomfort
• Tremors
• Alopecia (hair loss) 
• Phlebitis (inflammation of a vein)
• Hemolytic anemia (abnormal breakdown of red blood cells) 
• Mood changes
• Confusion 
• Anaphylaxis (life-threatening allergic reactions)

The information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of adjunct antimicrobials include:

• Acetohydroxamic acid
• Defencath
• Lithostat
• Taurolidine/citrate/heparin (pending FDA approval)