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Clinical evaluation of pivmecillinam in intractable urinary-tract infections with complications. A comparative study
Abstract:
A comparative study was made by the double-blind technique in order to make clear the usefulness of pivmecillinam in the treatment of intractable complicated urinary-tract infections using amoxicillin as a reference drug. Pivmecillinam was given in dosage of 400 mg (potency) per day which was one-fifth the dose of amoxicillin 2,000 mg (potency) per day. In global judgement, pivmecillinam was found superior to amoxicillin. It showed a "significant" superiority over amoxicillin for the treatment of, among others, the urinary-tract infections after prostatectomy, which are intractable diseases. When evaluated by symptoms, pivmecillinam improved bacteriuria "significantly" better than amoxicillin. When seen by causative organisms, the pivmecillinam treatment was "significantly" superior to the amoxicillin treatment against E. coli infections. Pivmecillinam was active against amoxicillin-resistant E. coli. Incidence of adverse reactions was less frequent with pivmecillinam than with amoxicillin. These results indicate that pivmecillinam is a drug of high usefulness for the treatment of intractable complicated urinary-tract infections when evaluated using amoxicillin as a reference drug.
Insights
Pivmecillinam demonstrated superior efficacy compared to amoxicillin in treating complicated urinary tract infections, including those resistant to amoxicillin. This antibiotic also showed a better safety profile, making it a valuable option for intractable UTIs.
Area of Science:
- Urology
- Infectious Diseases
- Pharmacology
Background:
- Complicated urinary tract infections (cUTIs) present significant treatment challenges.
- Intractable cUTIs, particularly post-prostatectomy, require effective therapeutic options.
- Amoxicillin is a commonly used antibiotic for UTIs, serving as a reference for comparison.
Purpose of the Study:
- To evaluate the clinical usefulness of pivmecillinam versus amoxicillin for intractable complicated urinary tract infections.
- To compare the efficacy and safety profiles of pivmecillinam and amoxicillin in a double-blind study.
Main Methods:
- A double-blind comparative study design.
- Patients received either pivmecillinam (400 mg/day) or amoxicillin (2,000 mg/day).
- Efficacy was assessed by global judgment, symptom improvement (bacteriuria), and causative organism eradication (E. coli).
Main Results:
- Pivmecillinam showed a significantly superior global efficacy compared to amoxicillin.
- Significant improvements in bacteriuria were observed with pivmecillinam.
- Pivmecillinam was significantly more effective against E. coli infections, including amoxicillin-resistant strains.
- Lower incidence of adverse reactions was reported with pivmecillinam.
Conclusions:
- Pivmecillinam is a highly useful therapeutic option for intractable complicated urinary tract infections.
- Its superior efficacy and favorable safety profile make it a valuable alternative to amoxicillin.
- Pivmecillinam demonstrates particular benefit in treating infections caused by E. coli, including resistant strains.