Nicolle L E
Department of Internal Medicine, University of Manitoba, Canada.
Int J Clin Pract. 1999 Dec;53(8):612-7.
Pivmecillinam is a beta-lactam antimicrobial marketed almost two decades ago. It has been used widely for the treatment of acute cystitis in selected areas of the world, particularly in Scandinavia. With increasing resistance of community Escherichia coli isolates to trimethoprim and trimethoprim/sulphamethoxazole, as previously observed for ampicillin and sulphonamides, reassessment of empiric antimicrobial regimens for acute uncomplicated urinary infection is necessary. Thus, it is timely to revisit the role of pivmecillinam for the treatment of acute cystitis. Clinical studies document the efficacy of this antimicrobial with short course therapy for acute cystitis, and clinical practice in countries where it has been used for many years confirms its efficacy and tolerability. If this agent were more widely used for empiric treatment for acute cystitis, use of antimicrobials such as the quinolones might be avoided. Further trials to define the comparative efficacy of pivmecillinam with other antimicrobials, and further studies of community resistance in E. coli isolates to this agent are needed.
匹美西林是一种近二十年前上市的β-内酰胺类抗菌药物。它已在世界某些地区广泛用于治疗急性膀胱炎，尤其是在斯堪的纳维亚半岛。正如之前观察到的氨苄西林和磺胺类药物那样，随着社区分离的大肠埃希菌对甲氧苄啶和甲氧苄啶/磺胺甲恶唑的耐药性增加，有必要重新评估急性单纯性泌尿系统感染的经验性抗菌治疗方案。因此，适时重新审视匹美西林在治疗急性膀胱炎中的作用很有必要。临床研究证明了这种抗菌药物用于急性膀胱炎短程治疗的疗效，并且在使用该药物多年的国家的临床实践证实了其疗效和耐受性。如果这种药物能更广泛地用于急性膀胱炎的经验性治疗，或许可以避免使用喹诺酮类等抗菌药物。需要进一步试验来确定匹美西林与其他抗菌药物的比较疗效，以及对社区分离的大肠埃希菌对该药物耐药性的进一步研究。
