৳ 12/unit
Pack: ৳ 12
৳ 12/unit
Pack: ৳ 12
At a glance
Pivmecillinam is an antibiotic used for treatment of infections caused by mecillinam-sensitive organisms, including acute cystitis, complicated urinary tract infections, salmonellosis, shigellosis, enteropathic E. coli diarrhea, gram-negative septicemia, and biliary infections.
Indications
- Acute cystitis
- Complicated urinary tract infections
- Salmonellosis (including enteric fever)
- Shigellosis
- Enteropathic E. coli diarrhea
- Gram-negative septicemia
- Biliary infections
Pharmacology
Pivmecillinam is a prodrug of mecillinam which is hydrolyzed in vivo to active mecillinam. Mecillinam interferes with bacterial cell wall synthesis, but the site of action differs from other penicillins. It is active against many gram-negative bacteria including Enterobacteriaceae (E. coli, Klebsiella, Proteus, Enterobacter, Salmonella, Shigella, Yersinia). It has poor activity against gram-positive organisms.
Dosage
Adult Dose (Oral):
- Usual dose: 1-2 tablets 3 times daily according to severity
- Acute uncomplicated cystitis: Initially 400 mg, then 200 mg every 8 hours for 3 days
- Chronic or recurrent bacteriuria: 400 mg every 6-8 hours
- Salmonellosis (including enteric fever): 1.2-2.4 g daily for 14 days; carriage elimination: 2-4 weeks
- Complicated UTI: 1-2 weeks
- Prophylaxis of recurrent UTI: 1 tablet every evening
Pediatric Dose (Oral):
- <20 kg: 20-60 mg/kg in 3-4 divided doses
- >20 kg: Adult dose
- Shigellosis: 20 mg/kg 4 times daily for 5 days
- UTI: 20-40 mg/kg/day in 3-4 divided doses
- Salmonellosis: 30-60 mg/kg/day in 3-4 divided doses
Side effects
Common Side Effects:
- Nausea
- Vomiting
- Diarrhea
- Indigestion
- Skin rashes
- Hypersensitivity reactions (urticaria, fever, joint pains, angioedema, serum sickness-like reactions)
- Hemolytic anemia
- Interstitial nephritis
- Neutropenia, thrombocytopenia
- CNS toxicity (including convulsions)
- Antibiotic-associated colitis
- Induction of carnitine deficiency
- Potentially fatal: Anaphylaxis
Use in pregnancy
Use in Pregnancy: Avoid during pregnancy; approximately 1/3 of serum levels found in umbilical cord and low but detectable amounts in amniotic fluid.
Pregnancy Category: B — always consult a doctor before taking during pregnancy.
Precautions & warnings
- Very high doses in poor renal function (risk of neurotoxicity) or heart failure
- Avoid contact (skin sensitization may occur)
- Monitor serum K concentration, renal and hematological status
- Spirochete infections (especially syphilis); suprainfection with penicillin-resistant organisms with prolonged use
- Avoid intrathecal route
- May cause esophageal injury
Overdose effects
No overdose experience; excessive doses likely to cause nausea, vomiting, and gastritis; treatment: symptomatic and supportive; hemodialysis may reduce blood levels.
Storage conditions
Store in a cool and dry place, protected from light and moisture.