Acute uncomplicated cystitis, Chronic or recurrent bacteriuria
Adult Dose
Oral
Acute uncomplicated cystitis
Adult: Initially 400 mg followed by 200 mg tid for 8 doses.
Chronic or recurrent bacteriuria
Adult: 400 mg 3-4 times daily.
Child Dose
Oral
Acute uncomplicated cystitis
Child: <40 kg with UTI: 20-40 mg/kg/day in 3-4 divided doses.
Chronic or recurrent bacteriuria
Child: <40 kg with UTI: 20-40 mg/kg/day in 3-4 divided doses.
Contraindication
Hypersensitivity, porphyria.
Mode of Action
Pivmecillinam has the antimicrobial activity of mecillinam to which it is hydrolysed in vivo. It interferes with the synthesis of bacterial cell wall. It is active against many gm-ve bacteria, esp Enterobacteriaceae including Escherichia coli, Enterobacter, Klebsiella, Salmonella and Shigella spp; indole-positive Proteus and Serratia marcescens are resistant. It is inactivated by beta-lactamases, but is more stable than ampicillin.
Precaution
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 haematological status. Spirochete infections particularly syphilis; suprainfection with penicillin-resistant organisms with prolonged use; avoid intrathecal route. May cause oesophageal injury.
Probenecid prolongs T1/2 of pivmecillinam. May cause prolonged bleeding when taken with anticoagulants. May decrease the efficacy of oral contraceptives. Increased risk of carnitine deficiency when used with valproate.
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The information provided herein is accurate, updated and complete as per the best practices of the Company. Please note that this information should not be treated as a replacement for physical medical consultation or advice. We do not guarantee the accuracy and the completeness of the information so provided. The absence of any information and/or warning to any drug shall not be considered and assumed as an implied assurance of the Company. We do not take any responsibility for the consequences arising out of the aforementioned information and strongly recommend you for a physical consultation in case of any queries or doubts.