Malakoplakia Medication

Updated: Apr 16, 2019
  • Author: Amira M Elbendary, MD, MBBCh, MSc; Chief Editor: William D James, MD  more...
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Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.



Class Summary

Antimicrobials directed against gram-negative bacteria, especially E coli, are used to treat patients with malakoplakia. In addition, antibiotics that concentrate in macrophages are used. Quinolone antibiotics (eg, ciprofloxacin) and sulfonamides (eg, trimethoprim-sulfamethoxazole) are indicated. Bethanechol and ascorbic acid have also been used in the treatment of patients with malakoplakia.

Ciprofloxacin (Cipro)

Ciprofloxacin is a fluoroquinolone that has activity against Pseudomonas and Streptococcus species, MRSA, Staphylococcus epidermidis, and most gram-negative organisms but has no activity against anaerobes. It inhibits bacterial DNA synthesis and, consequently, growth. Continue treatment for at least 2 days (7-14 days typical) after signs and symptoms have disappeared.

Trimethoprim and sulfamethoxazole (Bactrim, Bactrim DS, Septra, Septra DS)

Trimethoprim and sulfamethoxazole inhibit bacterial growth by inhibiting synthesis of dihydrofolic acid. The antibacterial activity of this combination of drugs includes common urinary tract pathogens except P aeruginosa.


Cholinergic agents

Class Summary

These agents increase the contractility of the bladder.

Bethanechol hydrochloride (Duvoid, Myotonachol, Urabeth, Urecholine)

Bethanechol hydrochloride is used for selective stimulation of the bladder to produce contractions to initiate micturition and to empty the bladder. It has been found to be most useful in patients who have bladder hypocontractility, provided they have functional and coordinated sphincters. Bethanechol hydrochloride is rarely used because of the difficulty in timing the effect and because of gastrointestinal tract stimulation.



Class Summary

Vitamins with the ability to induce collagen fibril synthesis are used.

Ascorbic acid (C-Crystals, Ascorbicap, Cevi-Bid, Vita-C)

Ascorbic acid is used for collagen synthesis and tissue repair.