Pivampicillin hydrochloride

Values obtained after the oral administration of single equimolar (800- j,mol) doses of either ampicillin (or amoxicillin) or an ester of ampicillin ampicillin, 278 mg amoxicillin, 291 mg bacampicillin hydrochloride, 400 mg and pivampicillin hydrochloride, 398 mg (Sjovall et al., 1978). 

The advantages of pivampicillin realized in animals carried through to humans. When 358 mg of pivampicillin hydrochloride (equivalent to 250 mg of ampicillin) was administered orally to 10 human volunteers, the average peak serum concentration obtained after 1 hr was 5.83 versus 1.72 (xg/ml obtained 1.5 hr after a 250-mg oral dose of ampicillin. The total urinary recovery 6 hr after the oral administration of pivampicillin was 73%. Only 29% of a like dose of ampicillin was recovered in the urine. The peak serum levels and urinary recovery of ampicillin obtained after oral administration of pivampicillin are very similar to those reported after intramuscular administration of ampicillin (Klein and Finland, 1963), suggesting nearly complete absorption of pivampicillin. 

Aluminium/magnesiium hydroxide and aluminium hydroxide do not significantly affect the bioavailability of amoxicillin or amoxicillin with clavulanic acid (co-amoxiclav). Antacids may reduce the absorption of the hydrochloride salt of pivampicillin. 

The UK manufacturers used to recommend that, because antacids may decrease pivampicillin absorption, concurrent use should be avoided. This warning relates to a hydrochloride salt formulation, which needs acidic conditions for optimal absorption, whereas the basic salt formulation should not be affected by any pH change. ... 

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