What is pivmecillinam?
Pivmecillinam is an antibiotic from the Penicillin group developed specifically for the treatment of urinary tract infections. It is a prodrug that is converted into mecillinam in the body.
The special advantage: Pivmecillinam can also be safely used in pregnancy and has very low resistance rates. It acts specifically against Gram-negative bacteria such as E. coli – the most common pathogen of bladderitis.
The brand name is Selexid® (formerly X-Systo®).
Active Ingredients & Mechanism of Action
Active ingredient: Pivmecillinam
Pivmecillinam is activated in the body to Mecillinam:
Active mechanism:
- Prodrug: Intestine Pivmecillinam is converted to Mecillinam
- Mecillinam binds to PBP2 (penicillin-binding protein 2)
- inhibits cell wall synthesis of bacteria
- Leads to the death of the bacteria
speciality: Mecillinam binds specifically to PBP2, not like other penicilline to PBP1 and PBP3. This has a different spectrum of action and fewer cross resistances.
Activity spectrum:
- E. coli (main pathogen)
- Clebsiella
- Proteus mirabilis
- Citrobacter
- Enterobacter
Who is it suitable for?
Pivmecillinam is suitable for:
- Acute uncomplicated urinary path infections
- Bubble inflammation in pregnancy
- Recurrent urinary path infections
Advantages:
- Safe in pregnancy
- Low resistance rates
- Hardly influence the intestinal flora
- Good compatibility
Not suitable for:
- Pyelonephritis
- Penicillin allergy
- Heavy kidney failure
Available Dosages
Acute bladder inflammation:
- 400 mg 3x daily for 3-5 days OR
- 400 mg 2x daily for 5-7 days
Available starches:
- Tablets 200 mg, 400 mg
In pregnancy: Same dosage, treatment period after medical instruction (often 5-7 days).
How to Take
Intake:
- During or after a meal (better recording)
- With a glass of water
- The tablets swallow completely, do not chew
Language:
- At least 3 days, usually 5-7 days
- In pregnancy often longer
- Complete the entire treatment
**
- Drink a lot (at least 2 litres per day)
- Pay attention to sufficient urine production
- Visit doctor for fever or flank pain
Contraindications
**Pivmecillinam must not be taken at:* *
- Penicillin allergy
- Heavy kidney failure
- Carnitine deficiency or carnitine metabolic disorders
- Sophistication
Preview at:
- Light to medium kidney failure
- Porphyry
- For long-term use: monitor carnitine levels
pregnant: Can be used in all trimesters. Security well proven.
Style time: Go only in small amounts into breast milk. Application possible.
Possible Side Effects
Acid (1-10%):
- nausea
- diarrhea
- stomach pain
- Break.
Occasionally:
- Headaches
- Squeeze
- Skin rash
- Vaginal mushroom
Selten:
- Allergic reactions
- Blood-image changes
- Carnitine deficiency (for long-term therapy)
** Compared to other antibiotics, Pivmecillinam influences the intestinal flora less strongly.
Interactions
Reactions:
- Probeecid – increased Mecillinam mirror
- Valproic acid - Carnitine deficiency increased
No relevant interactions with:
- Hormonal contraception
- Most other medicines
speciality: For long-term use, Pivmecillinam can increase the carnitine precipitation. For months-long prophylaxis: check carnitine levels.
Frequently Asked Questions
Similar Medications
Is pivmecillinam right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor. Read the package leaflet before use.