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Pivmecillinam plus pivampicillin in urinary tract infections: a randomized, open comparison with co-trimoxazole in
Abstract:
The efficacy and tolerance of a fixed-dose combination of 200 mg pivmecillinam and 250 mg pivampicllin was compared with that of co-trimoxazole (800 mg sulphamethoxazole plus 160 mg trimethoprim) in 42 hospital in-patients with complicated urinary tract infections. Patients received a 10-day course of tablets of either agent twice daily. The infecting organisms, which were Enterobacteriaceae (79%) and enterococci (21%), were eradicated in 17(89%) of the 19 patients given co-trimoxazole and in all 23 subjects who received pivmecillinam/pivampicillin. Sixteen (89%) of the 18 symptomatic patients responded clinically to co-trimoxazole. Pivmecillinam/pivampicillin was effective in 19 (95%) of 20 patients with symptomatic infections. There was a fairly good correlation between the bacteriological and clinical responses. No serious side-effects were recorded and all patients completed the prescribed course of treatment.
Insights
Pivmecillinam/pivampicillin demonstrated high efficacy and tolerance in treating complicated urinary tract infections, outperforming co-trimoxazole in bacterial eradication and clinical response. Both treatments were well-tolerated by hospitalized patients.
Area of Science:
- Pharmacology
- Infectious Diseases
- Urology
Background:
- Complicated urinary tract infections (cUTIs) require effective antimicrobial therapy.
- Enterobacteriaceae and enterococci are common pathogens in cUTIs.
- Evaluating alternative antibiotic regimens is crucial for managing resistant infections.
Purpose of the Study:
- To compare the efficacy and tolerance of a fixed-dose combination of pivmecillinam and pivampicillin against co-trimoxazole for complicated urinary tract infections.
- To assess bacteriological eradication and clinical response rates in hospitalized patients.
Main Methods:
- A comparative study involving 42 hospital in-patients with complicated urinary tract infections.
- Patients received either pivmecillinam/pivampicillin or co-trimoxazole (sulphamethoxazole/trimethoprim) for a 10-day course, twice daily.
- Bacteriological eradication and clinical response were assessed.
Main Results:
- Pivmecillinam/pivampicillin achieved 100% bacterial eradication in 23 patients, compared to 89% in 19 patients receiving co-trimoxazole.
- Clinical response rates were 95% for pivmecillinam/pivampicillin (19/20 patients) and 89% for co-trimoxazole (16/18 patients).
- No serious side-effects were reported for either treatment group, with full treatment completion by all patients.
Conclusions:
- The fixed-dose combination of pivmecillinam/pivampicillin is a highly effective and well-tolerated option for treating complicated urinary tract infections.
- Both pivmecillinam/pivampicillin and co-trimoxazole show good efficacy and tolerance, with pivmecillinam/pivampicillin demonstrating superior bacterial eradication rates.
- The study supports the use of pivmecillinam/pivampicillin as a viable treatment for complicated UTIs in hospitalized patients.