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Pivmecillinam for Uncomplicated Lower Urinary Tract Infections Caused by Staphylococcus saprophyticus—Cumulative Observational Data from Four Recent Clinical Studies

1
Department of Clinical Microbiology, Hvidovre Hospital, University of Copenhagen, 2650 Hvidovre, Denmark
2
Department of Clinical Microbiology, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark
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Division of Medicine, Stavanger University Hospital, 4068 Stavanger, Norway
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Antibiotic Centre of Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo, 0318 Oslo, Norway
5
Section of General Practice and Research Unit of General Practice, Department of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark
*
Author to whom correspondence should be addressed.
Received: 9 April 2019 / Revised: 24 April 2019 / Accepted: 30 April 2019 / Published: 7 May 2019
Objectives: To investigate pivmecillinam´s efficacy in uncomplicated lower urinary tract infection (UTI) caused by Staphylococcus saprophyticus—considered non-susceptible to mecillinam. Methods: Participants with confirmed UTIs caused by S. saprophyticus from four randomized controlled trials, where pivmecillinam was empirically given to females with symptoms of UTIs. The primary outcome was defined as a cumulative clinical effect—symptom resolution during the first eight days of therapy, without a recurrence of UTI symptoms in the long-term follow-up (approximately four weeks). Secondary outcomes included the bacteriological effect—elimination of the causative agent, with or without new uropathogenic bacteria present in the first control urine sample. Significant bacteriuria was defined as ≥103 bacteria/mL. The antibiotic susceptibility testing was done by disc diffusion methodology, according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST). Results: Seventy-four females (18–55 years) were empirically treated with pivmecillinam for UTIs caused by S. saphrophyticus (mean age 25 years; standard deviation (SD) 5.8). The cumulative clinical effect was 53/74 (72%), and the bacteriological effect was 51/59 (86%). Conclusion: Pivmecillinam showed a high clinical and bacteriological effect in UTIs caused by S. saprophyticus in these four clinical trials. The characterization of non-susceptibility for mecillinam regarding the treatment of UTIs caused by this common pathogen may need to be revised. View Full-Text
Keywords: Mecillinam; pivmecillinam; cystitis; UTI; Staphylococcus saprophyticus; mecillinam breakpoints Mecillinam; pivmecillinam; cystitis; UTI; Staphylococcus saprophyticus; mecillinam breakpoints
MDPI and ACS Style

Jansåker, F.; Bollestad, M.; Vik, I.; Lindbæk, M.; Bjerrum, L.; Frimodt-Møller, N.; Knudsen, J.D. Pivmecillinam for Uncomplicated Lower Urinary Tract Infections Caused by Staphylococcus saprophyticus—Cumulative Observational Data from Four Recent Clinical Studies. Antibiotics 2019, 8, 57. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8020057

AMA Style

Jansåker F, Bollestad M, Vik I, Lindbæk M, Bjerrum L, Frimodt-Møller N, Knudsen JD. Pivmecillinam for Uncomplicated Lower Urinary Tract Infections Caused by Staphylococcus saprophyticus—Cumulative Observational Data from Four Recent Clinical Studies. Antibiotics. 2019; 8(2):57. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8020057

Chicago/Turabian Style

Jansåker, Filip, Marianne Bollestad, Ingvild Vik, Morten Lindbæk, Lars Bjerrum, Niels Frimodt-Møller, and Jenny D. Knudsen 2019. "Pivmecillinam for Uncomplicated Lower Urinary Tract Infections Caused by Staphylococcus saprophyticus—Cumulative Observational Data from Four Recent Clinical Studies" Antibiotics 8, no. 2: 57. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics8020057

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