PIVMECILLINAM hydrochloride, 200mg, tab.

• Not in the WHO list of Essential Medicines 2025

Antibiotic, bioprecursor of mecillinam, chemically belonging to the beta-lactam family.

Active against Gram-negative enterobacterales incl. Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, Klebsiella oxytoca, Citrobacter koseri, Proteus vulgarisEnterobacter spp, Klebsiella (Enterobacter) aerogenes and Citrobacter freundii, including ESBL producers.

First-line treatment for lower urinary tract infections (UTIs), such as cystitis, caused by susceptible Enterobacteralesin women from 6 years of age and > 40 kg (infection limited to the bladder, without signs or symptoms of upper urinary tract, prostate, or systemic infection).

Not indicated for pyelonephritis, complicated UTIs, or use in men.

Tablets should be swallowed in a sitting or standing position, during a meal, with a large glass of water to reduce the risk of oesophageal ulceration. Patients should avoid lying down or going to bed for 30 minutes after taking the tablets.

The antibiotic treatment will be started only once urine analysis and antibiotic susceptibility testing (AST) results are available.

Monitor liver and kidney functions.

Pivmecillinam is an alternative to fluoroquinolones, amoxicillin/clavulanic acid, oral cephalosporins (with les impact on the emergence of resistances) and carbapenem since it is active against Extended Spectrum Beta Lactamase producing enterobacterales.