A Clinical Investigation of Pivmecillinam

Wise, Robert I.; Reeves, D. S.; Symonds, Jane; Wilkinson, P. J.

doi:10.1159/000221942

Cited by 9 publications

(4 citation statements)

References 2 publications

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“…These values are the same as those previously obtained by us (Williams et al, 1976) from studies in which an intramuscular injection and an oral solution were used; the values also agree well with those of 1.2 h after parenteral and 1.0-1.4 h after oral administration which were obtained by Roholt et al (1975). Slightly longer half-lives of 1.5-2.0 h were obtained by Wise et al (1976) from studies in patients who received two 200 mg capsules of pivmecillinam.…”

Section: Discussionsupporting

confidence: 89%

“…In the meantime Wise et al (1976) have published results from a patient study in which they obtained a mean peak serum mecillinam concentration of 3.9 Mg/ml after an oral 400 mg capsule dose of pivmecillinam. This value is higher than our own of 2.5 ug/ml but lower than the 5.0 ,ig/ml of the Roholt group although as the study by Wise et al (1976) was in patients their range of peak serum levels was predictably large being from 1.3-6.4 jg/ml. It is therefore apparent that different laboratories report considerably different plasma mecillinam concentrations after similar doses.…”

Section: Discussionmentioning

confidence: 99%

“…In our earlier paper dealing with the pharmacology of mecillinam (Williams et al, 1976) we discussed reasons why our serum mecillinam values were lower than those of Roholt and co-workers (1975). In the meantime Wise et al (1976) have published results from a patient study in which they obtained a mean peak serum mecillinam concentration of 3.9 Mg/ml after an oral 400 mg capsule dose of pivmecillinam. This value is higher than our own of 2.5 ug/ml but lower than the 5.0 ,ig/ml of the Roholt group although as the study by Wise et al (1976) was in patients their range of peak serum levels was predictably large being from 1.3-6.4 jg/ml.…”

Section: Discussionmentioning

confidence: 99%

“…Pivmecillinam and mecillinam are the oral and parenteral forms respectively of this new amidino penicillin which have been found to be effective in the treatment of urinary tract infections (Wise, Reeves, Symonds & Wilkinson, 1976) and enteric fever (Limson, 1973). Since the parent compound mecillinam is not absorbed from the gastrointestinal tract, studies on absorption have been carried out with the pivaloyl ester which is efficiently absorbed.…”

Section: Introductionmentioning

confidence: 99%

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Factors Influencing the Absorption and Disposition of Mecillinam and Pivmecillinam in Man

Andrews

Kendall

Mitchard

1976

Brit J Clinical Pharma

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In a pharmacokinetic study in six volunteers peak serum mecillinam concentrations were proportional to the oral dose of pivmecillinam at two dose levels of 200 and 400 mg. Effects of bed rest, probenecid and a 6 day course of treatment with pivmecillinam on serum mecillinam concentrations after an oral dose of pivmecillinam (two 200 mg capsules) have been investigated. Resting subjects had lower peak serum levels and a decreased rate of clearance than moderately active subjects, changes which are similar to those previously reported for benzylpenicillin. Pretreatment with probenecid produced significantly higher serum mecillinam levels, a longer serum antibiotic half‐life and a decreased rate of drug clearance which suggests that mecillinam is actively excreted by kidney tubules. Plasma mecillinam level profiles obtained after the first dose of a 6 day treatment period were not significantly different from corresponding values after the first dose on the seventh day which indicates that each dose of mecillinam is eliminated in healthy young adults before succeeding doses are taken.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Factors Influencing the Absorption and Disposition of Mecillinam and Pivmecillinam in Man

Andrews

Kendall

Mitchard

1976

Brit J Clinical Pharma

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A comparative trial of pivmecillinam and ampicillin in bacteriuria of pregnancy

et al. 1979

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A comparative trial of pivmecillinam and ampicillin was performed on 100 women with bacteriuria of pregnancy. They received either 400 mg pivmecillinam four times daily or 500 mg ampicillin four times daily for seven days. Cure rates at two weeks were 88% in the pivmecillinam group and 85% in the ampicillin group. At six weeks the respective rates were 76% and 64%. Failure of therapy was not associated with the appearance of bacterial resistance in either treatment group. Side-effects, particularly vomiting and premature cessation of therapy, were significantly more frequent in the pivmecillinam group. No significant effects on liver function were found. In subsequent patients treated in a non-comparative manner with 200 mg pivmecillinam three times daily, the incidence of side effects was markedly reduced with no loss of efficacy.

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Pivmecillinam in the treatment of therapy resistant urinary tract infections

Andersen¹,

Jøergensen²,

Lorenzen

1980

Infection

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Pivmecillinam is a new penicillin-like compound belonging to the so-called amidinopenicillins and characterized by a high antibacterial activity against Enterobacteriaceae and by demonstrated synergism when combined with other beta-lactam antibiotics. In this prospective trial geriatric patients with a stationary indwelling catheter and significant bacteriuria caused by Enterobacteriaceae were treated for four weeks with pivmecillinam, pivampicillin or various combinations of the two compounds. Urine specimens were obtained weekly, and in eight patients receiving pivmecillinam 75% of the urine samples were free from Enterobacteriaceae during the period of treatment. The figure was 91% in 24 patients receiving combination therapy. In seven patients treated with an equimolar dose of pivampicillin alone 43% and 23% of the urine specimens, controlled during the first and the second havles of the treatment period respectively, Enterbacteriaceae was eradicated. In this group there was a marked and increasing tendency towards infections caused by more resistant strains of Enterobacteriaceae as the treatment progressed. The latter is keeping with the observation that pivmecillinam, as opposed to ampicillin, apparently does not cause any selection of resistant Enterobacteriaceae in the faecal flora which is the main source of urinary pathogens.

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A Clinical Investigation of Pivmecillinam

Cited by 9 publications

References 2 publications

Factors Influencing the Absorption and Disposition of Mecillinam and Pivmecillinam in Man

Factors Influencing the Absorption and Disposition of Mecillinam and Pivmecillinam in Man

A comparative trial of pivmecillinam and ampicillin in bacteriuria of pregnancy

Pivmecillinam in the treatment of therapy resistant urinary tract infections

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