Treatment of acute pelvic infections with alphacillin (Pivampicillin Hcl)

Abstract

Pivanpicillin has been marketed for clinical use during the last few years. It has been used successfully in the treatment of Gonorrhea (Hunton et al,1974; Shah et al,1977), acute respiratory infections (Onadeko et al,1976; Pines et al,1974) and urinary tract infections (Fries, et al, 1973; Roholt, 1974). There is so far one published trial on the use of alphacillin in gynaecological infections (Jordheim, 1974) in which a satisfactory therapeutic effect was reported. Oral alphacillin (pivampicillin Hcl) is an ester of ampicillin, which is almost totally absorbed. After absorption, alphacillin is rapidly and virtually completely hydrolyzed to ampicillin by enzymes in sera, gastrointestinal mucosa, and other tissues. Because this absorption process is so efficient, pivampicillin gives rise to peak plasma levels of ampicillin, which are about three-fold higher than those achieved after molar equivalent oral doses of ampicillin itself and thjy cx;cur generally one hour after oral administration of alphacillin compared to approximately two hours after oral ampicillin. Higher urinary concentrations of ampicillin characteristicly occur. Generally twice the amount of antibiotic can be recovered from the urine following the administration of alphacillin than with molar equivalent oral doses of ampicillin.