Amdinocillin Pivoxil

Amdinocillin Pivoxil Uses, Dosage, Side Effects, Food Interaction and all others data.

Amdinocillin Pivoxil belongs to a new class of penicillin-the amdinopenicillin. Amdinocillin Pivoxil is a prodrug formulation of mecillinam which allows the drug to be administered by mouth. The prodrug form lacks antibacterial activity, but the active drug is liberated by enzymatic hydrolysis during absorption in the gastrointestinal tract.

Amdinocillin Pivoxil is bactericidal. It acts by interfering with bacterial cell wall synthesis, but the site of action differs from that of other penicilins. Amdinocillin Pivoxil is very active against Enterobacteriaceae. It is active against E. coli, Klebsiella, Proteus, Enterobacter, Salmonella, Shigella and Yersinia. Amdinocillin Pivoxil has poor activity against Gram- positive organisms. It has poor activity against Pseudomonas aeruginosa and has practically no activity against Enterococcus faecalis.

Amdinocillin Pivoxil is a pivaloyloxymethyl ester of amdinocillin that is well absorbed orally, but broken down to amdinocillin in the intestinal mucosa. It is active against gram-negative organisms and used as for amdinocillin.

Amdinocillin Pivoxil
Uses
Dosage
Side Effect
Precautions
Interactions
Uses during Pregnancy
Uses during Breastfeeding
Accute Overdose
Food Interaction
Half Life
Volume of Distribution
Clearance
Interaction With other Medicine
Contradiction
Storage

Trade Name	Amdinocillin Pivoxil
Generic	Pivmecillinam
Pivmecillinam Other Names	Amdinocillin pivoxil, Pivmecilinamo, Pivmecillinam, Pivmecillinamum
Type
Formula	C₂₁H₃₃N₃O₅S
Weight	Average: 439.569 Monoisotopic: 439.214091871
Groups	Approved
Therapeutic Class	Mecillinams
Manufacturer
Available Country
Last Updated:	September 19, 2023 at 7:00 am

Uses

Amdinocillin Pivoxil is used for treatment of infections caused by mecillinam-sensitive organisms, e.g. acute cystitis, complicated urinary tract infections, salmonellosis, shigellosis, enteropathic E. coli diarrhoea, gram-negative septicaemia, billiary infections.

Amdinocillin Pivoxil is also used to associated treatment for these conditions: Urinary tract infection caused by E. coli, Urinary tract infection caused by enterobacteria, Urinary tract infection caused by klebsiella, Urinary tract infection caused by proteus

How Amdinocillin Pivoxil works

Amdinocillin Pivoxil interferes with the biosynthesis of the bacterial cell wall however its activity is slightly different from that of other penicillins and cephalosporins

Dosage

Amdinocillin Pivoxil dosage

Adults:

The usual dose: 1-2 tablets 3 times daily according to severity of the infection.
In acute uncomplicated cystitis:initially 400 mg then 200 mg every 8 hours for 3 days.
In chronic or recurrent bacteriurea:400 mg 6-8 hours.
For the treatment of salmonellosis (including enteric fever):1.2-2.4 gm daily for 14 days. To eliminate salmonella carriage, therapy may be prolonged for 2-4 weeks. In complicated urinary tract infection the usual treatment time is 1-2 weeks.
For prophylactic treatment of recurrent urinary tract infections: 1 tablet every evening is recommended.

Children:

Weighing less than 20 kg should be given 20-60 mg/kg divided into 3-4 daily doses. Those weighing more than 20 kg should receive normal adult dose.
In shigellosis:20 mg/kg 4 times a day for 5 days.
For UTI:20-40 mg/kg/day in 3-4 divided doses
For salmonellosis:30-60 mg/kg/day in 3-4 divided doses

The tablet should be taken with at least 50-100 ml fluid. As the bioavailability is practically unaffected by simultaneous food intake, This tablets are best taken with or immediately after a meal.

Side Effects

Amdinocillin Pivoxil is generally well tolerated, even by patients with reduced kidney function. Upper gastrointestinal disturbances such as nausea, vomiting and diarrhoea or indigestion may occur when a dose has been given on an empty stomach. Skin rashes have been reported in some cases, but the characteristic ampicillin-rash has never been observed, nor has there been any evidence of hepato-, nephro-, or ototoxicity. The occurrence of anaphylaxis, though not yet reported, cannot be entirely excluded.

Precaution

There is no experience with over dosage of pivmecillinam. However, excessive doses are likely to cause nausea, vomiting and gastritis. Treatment should be restricted to symptomatic and supportive measures. If necessary haemodialysis will reduce the blood level.

Food Interaction

Take with or without food. The absorption is unaffected by food.

Elimination Route

Well absorbed following oral administration.

Pregnancy & Breastfeeding use

Mecillinam concentrations approximately 1/3 of the serum levels have been found in the umbilical cord, and low but detectable amounts in the amniotic fluid. So, use of pivmecillinam in pregnancy should be avoided. Mecillinam is not excreted into the milk of lactating mother

Contraindication

There have been no reports on allergy to Amdinocillin Pivoxil among patients with a known history of hypersensitivity to penicillins and cephalosporins. Nevertheless, it seems reasonable to exclude such patients from treatment with Amdinocillin Pivoxil until further experience has been gained.

Special Warning

Based on information available to date for patients with impaired renal function, the initial dose can remain unchanged as can the interval between doses. However, the amount administered as the maintenance dose should be changed according to the following criteria:

CrCl 30 ml/min or greater: full dosage
CrCl 10-30 ml/min: 50% dosage
CrCl <10 ml/min: 25% dosage

Use of Amdinocillin Pivoxil in infants under 3 months of age should be avoided.