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Long-term treatment with pivmecillinam in patients with recurrent bacteriuria
Abstract:
Thirty out-patients with chronic recurrent urinary tract infections, who had failed to respond to 10 days treatment with either pivmecillinam and/or amoxycillin, received a 3-month course of pivmecillinam at a dose of 200 mg, three times daily. Twenty-seven patients had bacteriuria due to Enterobacteriaceae, mainly Escherichia coli, sensitive to mecillinam in vitro. Pivmecillinam eradicated all the initial urinary pathogens. Reinfections occurred during treatment in three patients, who remained asymptomatic. Four subjects complained of gastro-intestinal side-effects, and therapy was withdrawn in three instances. Another three patients described unusual adverse events towards the end of the course of treatment, described as an odd sensation in the body and a desire for salt. The sensation disappeared a few days after the end of treatment. Treatment with pivmecillinam had no adverse effect on haematopoietic, hepatic or renal function.
Insights
A 3-month course of pivmecillinam effectively treated chronic recurrent urinary tract infections in patients resistant to other antibiotics. Pivmecillinam eradicated pathogens with minimal side effects, showing good safety for long-term use.
Area of Science:
- Urology
- Infectious Diseases
- Pharmacology
Background:
- Chronic recurrent urinary tract infections (UTIs) pose a significant challenge, often requiring prolonged treatment.
- Many patients do not respond to standard antibiotic regimens like pivmecillinam or amoxicillin.
Purpose of the Study:
- To evaluate the efficacy and safety of a 3-month course of pivmecillinam for chronic recurrent UTIs.
- To assess treatment outcomes in patients previously unresponsive to standard antibiotic therapies.
Main Methods:
- A cohort of 30 outpatients with chronic recurrent UTIs received a 3-month course of pivmecillinam (200 mg, three times daily).
- Patients had previously failed treatment with pivmecillinam and/or amoxicillin.
- Bacteriuria analysis and in vitro sensitivity testing were performed.
Main Results:
- Pivmecillinam successfully eradicated initial urinary pathogens in all patients.
- 27 patients had bacteriuria caused by Enterobacteriaceae, primarily Escherichia coli, sensitive to mecillinam.
- Three patients experienced asymptomatic reinfections during treatment.
- Gastrointestinal side effects led to treatment withdrawal in three patients.
Conclusions:
- A 3-month course of pivmecillinam is effective in eradicating pathogens in chronic recurrent UTIs.
- Pivmecillinam demonstrates a favorable safety profile with no adverse effects on hematopoietic, hepatic, or renal function.
- This regimen offers a viable treatment option for patients with antibiotic-resistant UTIs.