Pivmecillinam is an active substance from the group of ß-lactam antibiotics. It is used in the treatment of uncomplicated urinary tract infections caused by mecillinam-sensitive bacteria. The antibiotic is mainly effective against Gram-negative enterobacteria such as Escherichia coli, Shigella and Salmonella, but not against Gram-positive bacteria.



Like other of the ß-lactam antibiotics, pivmecillinam interferes with the biosynthesis of the bacterial cell wall in that the opened ß-lactam ring inhibits the enzyme D-alanine transpeptidase. The terminal alanine residues can now no longer combine with glycine, resulting in instabilization of the cell wall and thus killing the bacterium.

The multiplication of the bacteria is inhibited by the antibiotic binding to penicillin binding protein 2 (PBP 2). Since other penicillins and cephalosporins mainly bind only to PBP 1 and 3, cross-resistance rarely occurs.


Pivmecillinam is an inactive precursor of mecillinam, which is well absorbed orally and degraded in the intestinal mucosa to amdinocillin. Like other penicillins, the half-life is only about one hour. The antibiotic is excreted primarily by the kidney.


Excretion of the antibiotic decreases with concomitant use with probenecid.
Pivmecillinam selbst reduziert die Ausscheidung des Zytostatikums Methotrexat.
Das Risiko eines Carnitinmangels erhöht sich bei gleichzeitiger Einnahme von Pivmecillinam mit Valproinsäure.


Side effects

The most common unwanted side effects of pivmecillinam include gastrointestinal symptoms such as nausea and diarrhea, and allergic reactions or skin rashes. Fungal infections of the vagina are also common.

Toxicological data

LD50 (mouse, oral): 3020 mg/kg
LD50 (Maus, intravenös): 475 mg/kg
LD50 (Maus, subkutan): 1736 mg/kg

Chemical & physical properties

ATC Code J01CA08
Formula C21H33N3O5S
Molar Mass (g·mol−1) 439,569
Physical State solid
Melting Point (°C) 119
PKS Value 8,9
CAS Number 32886-97-8
PUB Number 115163
Drugbank ID DB01605

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All information used for the content comes from verified sources (recognised institutions, experts, studies by renowned universities). We attach great importance to the qualification of the authors and the scientific background of the information. Thus, we ensure that our research is based on scientific findings.
Markus Falkenstätter, BSc

Markus Falkenstätter, BSc

Markus Falkenstätter is a writer on pharmaceutical topics in Medikamio's medical editorial team. He is in the last semester of his pharmacy studies at the University of Vienna and loves scientific work in the field of natural sciences.

Mag. pharm. Stefanie Lehenauer

Mag. pharm. Stefanie Lehenauer

Stefanie Lehenauer has been a freelance writer for Medikamio since 2020 and studied pharmacy at the University of Vienna. She works as a pharmacist in Vienna and her passion is herbal medicines and their effects.

The content of this page is an automated and high-quality translation from DeepL. You can find the original content in German here.


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