pivmecillinam + amoxicillin + clavulanic acid

This is an oral combination therapy consisting of three active pharmaceutical ingredients: - **Pivmecillinam** is a prodrug of mecillinam, a beta-lactam antibiotic (amidino-penicillin) that selectively binds to penicillin-binding protein 2 (PBP2) in Gram-negative bacteria, inhibiting cell wall synthesis and leading to bacterial cell death. It is particularly effective against Enterobacterales and has been used for decades in Europe for urinary tract infections. - **Amoxicillin** is a broad-spectrum beta-lactam antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins. - **Clavulanic acid** is a beta-lactamase inhibitor that protects amoxicillin from degradation by beta-lactamase enzymes produced by resistant bacteria. The combination aims to provide broad-spectrum coverage against multidrug-resistant Gram-negative pathogens, including extended spectrum beta-lactamase (ESBL)-producing Enterobacterales. The addition of clavulanic acid extends the activity of amoxicillin against organisms producing certain types of beta-lactamases. This regimen has been studied as step-down oral therapy following intravenous antibiotics in hospitalized adults with febrile urinary tract infections caused by ESBL-producing bacteria[1][4][7]. Clinical trials are ongoing to determine its non-inferiority compared with standard regimens such as ciprofloxacin or ertapenem[1][3][10].

Brand names

Augmentin

Other names

pivmecillinam and amoxicillin/clavulanic acidPAC