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Comparison of pivmecillinam and cephalexin in acute uncomplicated urinary tract infection

A P Menday1

  • 1Leo Pharmaceuticals, Princes Risborough, Bucks, UK. paul.menday@leo-pharma.com

International Journal of Antimicrobial Agents
|March 21, 2000
PubMed

Insights

A 3-day course of pivmecillinam effectively treats uncomplicated urinary tract infections, showing comparable results to a 7-day cephalexin regimen. This short-course antibiotic therapy is well-tolerated and a viable option for acute cystitis.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Urology

Background:

  • Urinary tract infections (UTIs) are common, often caused by Escherichia coli.
  • Short-course antibiotic regimens are desirable to improve patient compliance and reduce side effects.
  • Pivmecillinam is an antibiotic effective against common UTI pathogens.

Purpose of the Study:

  • To compare the clinical and bacteriological efficacy of a 3-day pivmecillinam course versus a 7-day cephalexin course for acute, uncomplicated UTIs.
  • To assess the tolerability of both treatment regimens.

Main Methods:

  • A randomized clinical trial involving 216 patients with bacteriologically confirmed UTIs.
  • Patients received either pivmecillinam (200 mg TID for 3 days) or cephalexin (250 mg QID for 7 days).
  • Clinical and bacteriological outcomes, including Escherichia coli eradication, were evaluated.

Main Results:

  • Clinical cure/improvement rates were high for both groups: 95.3% for pivmecillinam and 93.6% for cephalexin.
  • Bacteriological success rates were 89.7% for pivmecillinam and 81.7% for cephalexin.
  • Escherichia coli eradication rates were 90.1% for pivmecillinam and 80.6% for cephalexin. Both treatments were well tolerated.

Conclusions:

  • A 3-day course of pivmecillinam is clinically and bacteriologically effective for uncomplicated cystitis.
  • Pivmecillinam offers a well-tolerated, shorter treatment option compared to standard cephalexin regimens.
  • Short-course pivmecillinam demonstrates high efficacy, particularly against Escherichia coli, in treating acute UTIs.

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