Effect of pivmecillinam hydrochloride was evaluated on 20 patients with cystitis and 13 patients with urethritis seen in urologic department of Kyungpook National University Hospital during past 4 months periods from April 1982 through August 1982. Pivmecillinam was given orally at a dose of 600mg (3 tablets) tid for 4 days (total 12 tablets) and following results were obtained. 1. In cystitis, effective result was observed in 19 out of 20 patients, giving therapeutic rate of 95%, and pivmecillinam was effective against all G (-) bacilli infections including E. coli except pseudomonas infection in 1. 2. In urethritis, effective result was noticed in 9 out of 13 patients, giving therapeutic rate of 70%, and pivmecillinam was effective against staphylococcus infection in 6 out of 7 patients, serratia infection in 1 out of 2 and G (-), bacilli infection in 1. However, it was ineffective against staphylococcus, serratia, enterococcus and unknown organism in 1 case, respectively. 3. As to the side effect, only diarrhea was observed in one of total 33 patients.
Amdinocillin Pivoxil* ; Anti-Bacterial Agents ; Cystitis ; Diarrhea ; Enterococcus ; Gyeongsangbuk-do ; Humans ; Pseudomonas Infections ; Serratia ; Serratia Infections ; Staphylococcus ; Urethritis ; Urinary Tract Infections* ; Urinary Tract*

Effect of pivmecillinam hydrochloride was evaluated on 20 patients with cystitis and 13 patients with urethritis seen in urologic department of Kyungpook National University Hospital during past 4 months periods from April 1982 through August 1982. Pivmecillinam was given orally at a dose of 600mg (3 tablets) tid for 4 days (total 12 tablets) and following results were obtained. 1. In cystitis, effective result was observed in 19 out of 20 patients, giving therapeutic rate of 95%, and pivmecillinam was effective against all G (-) bacilli infections including E. coli except pseudomonas infection in 1. 2. In urethritis, effective result was noticed in 9 out of 13 patients, giving therapeutic rate of 70%, and pivmecillinam was effective against staphylococcus infection in 6 out of 7 patients, serratia infection in 1 out of 2 and G (-), bacilli infection in 1. However, it was ineffective against staphylococcus, serratia, enterococcus and unknown organism in 1 case, respectively. 3. As to the side effect, only diarrhea was observed in one of total 33 patients.
Amdinocillin Pivoxil* ; Anti-Bacterial Agents ; Cystitis ; Diarrhea ; Enterococcus ; Gyeongsangbuk-do ; Humans ; Pseudomonas Infections ; Serratia ; Serratia Infections ; Staphylococcus ; Urethritis ; Urinary Tract Infections* ; Urinary Tract*

BACKGROUND: Mecillinam, an amidinopenicillin antibiotic, has been used to treat urinary tract infections and bacterial enteritis in many countries. In this study, we evaluated in vitro activity of mecillinam against Enterobacteriaceae isolates from urine, and Salmonella and Shigella isolates from patients with bacterial gastroenteritis. MATERIALS AND METHODS: A total of 308 clinical strains were collected and were comprised of Escherichia coli (n=109), Klebsiella pneumoniae (n=52), Enterobacter spp. (n=30), Serratia marcescens (n=30) and Proteus spp. (n=29) isolated from a university hospital in Korea in 2007, and of Salmonella spp. (n=28) and Shigella spp. (n=30) isolated from Korean diarrheal patients from 2001 to 2006. Antimicrobial susceptibility was tested by Clinical Laboratory Standard Institute (CLSI) agar dilution method. CLSI breakpoint of mecillinam for E. coli urinary tract isolates was applied to all other isolates. RESULTS: In E. coli, rate of susceptibility to ampicillin was 30%, but 99-100% to amikacin and cefotaxime. Most (96%) of E. coli isolates, including extended-spectrum beta-lactamase (ESBL) producers, were susceptible to mecillinam. All ESBL producers, except for one isolate, were inhibited by < or =4 microg/mL of mecillinam. MIC90 of mecillinam for K. pneumoniae and Enterobacter spp. was 8 microg/mL and 1 microg/mL, respectively, and the susceptibility rate was 92% and 97%, respectively. However, MIC90 of mecillinam for S. marcescens isolates was >128 microg/mL and most of them were resistant to mecillinam. All Salmonella isolates and 27 of 30 Shigella isolates were susceptible to mecillinam. CONCLUSION: Mecillinam was active in vitro against most Enterobacteriaceae, Salmonella, and Shigella isolates except for S. marcescens. Therefore, mecillinam can be a good alternative agent for treating urinary tract infection and bacterial gastroenteritis.
Agar ; Amdinocillin ; Amikacin ; Ampicillin ; beta-Lactamases ; Cefotaxime ; Enteritis ; Enterobacter ; Enterobacteriaceae ; Escherichia coli ; Gastroenteritis ; Humans ; Klebsiella pneumoniae ; Korea ; Pneumonia ; Proteus ; Salmonella ; Serratia marcescens ; Shigella ; Urinary Tract ; Urinary Tract Infections

BACKGROUND: Mecillinam, an amidinopenicillin antibiotic, has been used to treat urinary tract infections and bacterial enteritis in many countries. In this study, we evaluated in vitro activity of mecillinam against Enterobacteriaceae isolates from urine, and Salmonella and Shigella isolates from patients with bacterial gastroenteritis. MATERIALS AND METHODS: A total of 308 clinical strains were collected and were comprised of Escherichia coli (n=109), Klebsiella pneumoniae (n=52), Enterobacter spp. (n=30), Serratia marcescens (n=30) and Proteus spp. (n=29) isolated from a university hospital in Korea in 2007, and of Salmonella spp. (n=28) and Shigella spp. (n=30) isolated from Korean diarrheal patients from 2001 to 2006. Antimicrobial susceptibility was tested by Clinical Laboratory Standard Institute (CLSI) agar dilution method. CLSI breakpoint of mecillinam for E. coli urinary tract isolates was applied to all other isolates. RESULTS: In E. coli, rate of susceptibility to ampicillin was 30%, but 99-100% to amikacin and cefotaxime. Most (96%) of E. coli isolates, including extended-spectrum beta-lactamase (ESBL) producers, were susceptible to mecillinam. All ESBL producers, except for one isolate, were inhibited by < or =4 microg/mL of mecillinam. MIC90 of mecillinam for K. pneumoniae and Enterobacter spp. was 8 microg/mL and 1 microg/mL, respectively, and the susceptibility rate was 92% and 97%, respectively. However, MIC90 of mecillinam for S. marcescens isolates was >128 microg/mL and most of them were resistant to mecillinam. All Salmonella isolates and 27 of 30 Shigella isolates were susceptible to mecillinam. CONCLUSION: Mecillinam was active in vitro against most Enterobacteriaceae, Salmonella, and Shigella isolates except for S. marcescens. Therefore, mecillinam can be a good alternative agent for treating urinary tract infection and bacterial gastroenteritis.
Agar ; Amdinocillin ; Amikacin ; Ampicillin ; beta-Lactamases ; Cefotaxime ; Enteritis ; Enterobacter ; Enterobacteriaceae ; Escherichia coli ; Gastroenteritis ; Humans ; Klebsiella pneumoniae ; Korea ; Pneumonia ; Proteus ; Salmonella ; Serratia marcescens ; Shigella ; Urinary Tract ; Urinary Tract Infections

INTRODUCTIONIncreasing resistance in Escherichia coli and Klebsiella pneumoniae to firstline antibiotics makes therapeutic options for urinary tract infections (UTIs) challenging. This study investigated the in vitro efficacies of 6 antibiotics against multidrug resistant (MDR) uropathogens.

MATERIALS AND METHODSMinimum inhibitory concentrations to ceftibuten, cefpodoxime, fosfomycin, mecillinam, temocillin, and trimethoprim were determined against 155 MDR-isolates of E. coli and K. pneumoniae. The presence of extended-spectrum beta-lactamases (ESBL) and plasmid-borne AmpC enzymes was determined by phenotypic testing with genotyping performed by multiplex polymerase chain reaction.

RESULTSTemocillin demonstrated highest susceptibility rates for both E. coli (95%) and K. pneumoniae (95%) when breakpoints for uncomplicated UTIs were applied; however, temocillin susceptibility was substantially lower when "systemic infection" breakpoints were used. Fosfomycin demonstrated the best in vitro efficacy of the orally available agents, with 78% and 69% of E. coli and K. pneumoniae isolates susceptible, respectively. The next most effective antibiotics were ceftibuten (45%) and mecillinam (32%). ESBL and ampC genes were present in 47 (30%) and 59 (38%) isolates.

CONCLUSIONThis study demonstrated few oral therapeutic options for MDR-uropathogens, with fosfomycin demonstrating the best in vitro activity.

Amdinocillin ; pharmacology ; Anti-Bacterial Agents ; pharmacology ; Bacterial Proteins ; genetics ; Ceftizoxime ; analogs & derivatives ; pharmacology ; Cephalosporins ; pharmacology ; Drug Resistance, Multiple, Bacterial ; genetics ; Escherichia coli ; drug effects ; genetics ; Escherichia coli Infections ; microbiology ; Fosfomycin ; pharmacology ; Genotype ; Humans ; In Vitro Techniques ; Klebsiella Infections ; microbiology ; Klebsiella pneumoniae ; drug effects ; genetics ; Microbial Sensitivity Tests ; Multiplex Polymerase Chain Reaction ; Penicillins ; pharmacology ; Singapore ; Trimethoprim ; pharmacology ; Urinary Tract Infections ; microbiology ; beta-Lactamases ; genetics