Mictral (Winthrop) is a newly formulated product for the treatment of lower urinary tract infection. It comes in sachets containing granules of nalidixic acid 660 mg, sodium citrate, citric acid and sodium bicarbonate. One sachet is taken thrice daily for 3 days. Nalidixic acid 500 mg is available alone as Negram (Sterling); two tablets are taken four times daily. Mictral’s formulation alkalinises the urine, and is intended to increase the excretion of free active drug. This should allow a smaller dose of nalidixic acid to be effective, so reducing those unwanted effects related to a high plasma concentration. The alkalinisation might also alleviate dysuria. The use of a 3-day course is in line with the current trend for shorter therapy in lower urinary tract infection.1
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