Abstract
A review of the history of research and development of, semisynthetic penicillins shows that studies aimed at development of oral preparations broadening of the spectrum of antimicrobial activity and development of compounds active against resistant Staphylococci, by chemical modifications of 6-aminopenicillanic acid with different radicals attached to the free amino gtoup at the 6-position of the acid have yielded a variety of new compounds. In-recent years, however, efforts have largely been directed to development of compounds with pronounced usefulness in the treatment of infections by Gram-negative bacilli because of the transfigurations of principal pathogens.
Pivmecillinam is a semisynthetic penicillin with profound activity specifically against Gramnegative bacilli, developed by LUND et al.1) in 1972 for oral administration.
Laboratory and clinical evaluations of this new antibiotic were reported at the Symposium on Pivmecillinam on the occasion of the 24th Congress of the Japan Society of Chemotherapy2) in 1976, where the drug was characterized as follows:
1) It is effective by oral administration in infections with Gram-negative bacilli such as E. coli, Klebsiella, Enterobacter, Citrobacter, or Proteus (including indole-positive species).
2) It is remarkably active against E. coli and is effective even against those E. coli strains resistant to ampicillin (ABPC) andjor amoxicillin (AMPC).
3) In general clinical trials, treatment with the drug even in doses of as low as 150-200mg (potency) per day unfailingly produced satisfactory clinical responses in patients with simple urinary tract infections. The drug is well tolerated and virtually devoid of adverse effects.
4) The usual single doses being relatively low, it can be supplied in the form of small tablets which are easy to swallow.
Our previous clinical experience with pivmecillinam in urinary tract infections yielded similar conclusions.3)
In order to evaluate the efficacy, usefulness and safety of pivmecillinam (PMPC) in the treatment of patients with acute simple cystitis we performed a double-blind clinical study on the drug using as control nalidixic acid (NA), an established drug frequently used with proven usefulness for this condition.
