Pivmecillinam (t% 1 h) is an oral agent closely related to the broad spectrum penicillins but with differing antibacterial activity by virtue of having a high affinity for penicillin binding protein. It is active against Gram-negative organisms including P-lactamase-producing Enterobacteriaceae but is inactive against Pseudomonas aeruginosa and its relatives, and against Gram-positive organisms. Pivmecillinam is hydrolysed in vivo to the active form mecillinam (which is poorly absorbed by mouth). It has been used to treat urinary tract infection. Diarrhoea and abdominal pain may occur.
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