PIVMECILLINAM hydrochloride, 200mg, tab.

• Not in the WHO list of Essential Medicines 2025

Anti-infective for systemic use

Antibiotic, bioprecursor of mecillinam, chemically belonging to the beta-lactam family.

Usually active against Gram-negative enterobacterales incl. Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, Klebsiella oxytoca, Citrobacter koseri, Proteus vulgarisEnterobacter spp, Klebsiella (Enterobacter) aerogenes and Citrobacter freundii, including ESBL producers.

First-line treatment of uncomplicated or simple cystitis caused by susceptible Enterobacterales, in women from 6 years of age and > 40 kg (infection limited to the bladder without signs/symptoms of upper tract, prostate, or systemic infection).

Not indicated in pyelonephritis, in men nor in UTIs associated with fever.

Tablets should be swallowed in a sitting or standing position, during a meal, with a large glass of water to reduce the risk of oesophageal ulceration. Patients should avoid lying down or going to bed for 30 minutes after taking the tablets.

The antibiotic treatment will be started only once urine analysis and antibiotic susceptibility testing (AST) results are available.

Monitor liver and kidney functions.

Pivmecillinam is an alternative to fluoroquinolones, amoxicillin/clavulanic acid, oral cephalosporins (with les impact on the emergence of resistances) and carbapenem since it is active against Extended Spectrum Beta Lactamase producing enterobacterales.