Pharmacokinetics of bacampicillin compared with those of ampicillin, pivampicillin, and amoxycillin

Bacampicillin, a new oral prodrug which in vivo is rapidly transformed to ampicillin, was compared with ampicillin, pivampicillin, and amoxycillin in a randomized cross-over study on 11 healthy volunteers. All drugs were given in oral doses equimolar to 400 mg of bacampicillin (800 mumol). The mean of the individual peak concentrations in serum was 8.3 mug/ml for bacampicillin, 7.1 mug/ml for pivampicillin, 7.7 mug/ml for amoxycillin, and 3.7 mug/ml for ampicillin. Furthermore, bacampicillin had a higher absorption rate than all the other drugs, although there were statistically significant differences only versus ampicillin. The peak serum levels of the individual subjects were more dispersed with ampicillin and amoxycillin, suggesting a more uniform absorption of bacampicillin and pivampicillin. The relative bioavailability of bacampicillin and pivampicillin was comparable, whereas ampicillin was only 2/3 that of the others.