pivmecillinam

Pivmecillinam is an orally active pivaloyloxymethyl ester prodrug of mecillinam (amdinocillin), a specialized amidinopenicillin antibiotic. It is primarily utilized for the treatment of uncomplicated urinary tract infections (UTIs). Unlike traditional penicillins that primarily target Penicillin-Binding Proteins 1 and 3 (PBP-1 and PBP-3), mecillinam exhibits high specificity for Penicillin-Binding Protein 2 (PBP-2) in Gram-negative bacteria, particularly Enterobacteriaceae like Escherichia coli. Binding to PBP-2 disrupts the maintenance of rod-like bacterial shape, resulting in the formation of ovoid or spherical cells (spheroplasts) that eventually undergo lysis. This unique target provides a synergistic effect when used in combination with other beta-lactams and helps maintain activity against many strains resistant to other penicillins. Originally developed by Leo Pharma, it has been a standard of care in Nordic countries for decades and received FDA approval in 2024 under the brand name Pivya.

Brand names

SelexidPivyaPenomaxCoactabs派文

Other names

amdinocillin pivoxilpivmecillinam hydrochloride