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 or pharmacist.
Important Safety Information
This service operates under German pharmaceutical law (HWG). For risks and side effects, read the package leaflet and consult your doctor or pharmacist. All medications are dispensed from a licensed pharmacy in Germany.