匹ひき美び西林にしばやし

**匹ひき美び西林にしばやし**
臨床りんしょう資料しりょう
商品しょうひん名めい（英えい语：Drug nomenclature）	Selexid、Penomax、Coactabs
AHFS/Drugs.com	Micromedex详细消しょう费者药物信しん息いき
懷ふところ孕分級きゅう	; 怀孕期き间安全あんぜん;
给药途と径みち	口くち服ふく
ATC碼	J01CA08 (WHO) ;
法律ほうりつ規範きはん狀態じょうたい
法律ほうりつ規範きはん	处方药（℞-only）;
藥物やくぶつ動力どうりょく學がく數かず據よりどころ
生物せいぶつ利用りよう度ど	低ひく
血漿けっしょう蛋白たんぱく結合けつごう率りつ	5至いたり10%（作さく为美西林にしばやし）
药物代だい谢	匹ひき美び西林にしばやし水みず解かい成美せいび西林にしばやし
生物せいぶつ半はん衰おとろえ期き	1至いたり3小しょう时
排泄はいせつ途と徑みち	肾和わ胆きも，通常つうじょう作さく为美西林にしばやし
识别信しん息いき
	IUPAC命名めいめい法ほう 2,2-dimethylpropanoyloxymethyl (2S,5R,6R)-6-[(azepan-1-ylmethylene)amino]-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylate; ;
CAS号ごう	32886-97-8
PubChem CID	36272;
ChemSpider	33356 ;
UNII	1WAM1OQ30B;
KEGG	D02889 ;
ChEMBL	ChEMBL1650818 ;
CompTox Dashboard（英えい语：CompTox Chemicals Dashboard） (EPA)	DTXSID7048538 ;
ECHA InfoCard	100.046.600
化学かがく信しん息いき
化学かがく式しき	C21H33N3O5S
摩ま尔质量りょう	439.57 g·mol−1
3D模型もけい（JSmol（英えい语：JSmol））	交互こうご式しき图像;
	SMILES CC1(C(N2C(S1)C(C2=O)N=CN3CCCCCC3)C(=O)OCOC(=O)C(C)(C)C)C;

匹ひき美び西林にしばやし（INN：Pivmecillinam；USAN：amdinocillin pivoxil）是これ美よし西林にしばやし（一いち种广谱青あお霉素类抗生こうせい素もと）的てき口くち服ふく活性かっせい前ぜん药。匹ひき美び西林にしばやし是ただし美び西林にしばやし的てき叔戊酰氧甲かぶと酯。

匹ひき美び西林にしばやし仅对革かわ兰氏阴性菌きん有ゆう活性かっせい，主要しゅよう用よう于治疗下尿にょう路ろ感染かんせん。在ざい北欧ほくおう国家こっか，自じ1970年代ねんだい以来いらい，它已被ひ广泛用よう于该适应症しょう。它已被ひ提ひさげ议作为急性せい膀胱ぼうこう炎えん经验性せい治ち疗的てき首くび选一线药物。^[1]^[2]它也被ひ用よう于治疗副ふく伤寒和わ志こころざし贺杆菌きん病びょう。^[3]

活性かっせい

有害ゆうがい影かげ响

匹ひき美び西林にしばやし的てき副作用ふくさよう与あずか其他青あお霉素相似そうじ。使用しよう美び西林にしばやし最さい常つね见的副作用ふくさよう是ぜ皮かわ疹和わ胃い肠道不ふ适，包括ほうかつ恶心和わ呕吐。^[1]^[4]

人ひと们早就知道どう，在ざい被ひ身体しんたい分解ぶんかい时会释放叔戊酸さん的てき前ぜん体からだ药物（如匹美び西林にしばやし、匹ひき氨西林りん和わ头孢妥仑匹ひき酯）会かい消耗しょうもう肉にく碱。^[5]^[6]这不是ぜ由よし于药物ぶつ本身ほんみ，而是由よし于叔戊つちのえ酸さん盐，叔戊酸さん盐主要しゅよう通どおり过与肉にく碱形成けいせい结合物ぶつ而从体内たいない清きよし除じょ。虽然短期たんき使用しよう这些药物会かい导致血液けつえき中肉ちゅうにく毒どく碱水平すいへい显着下降かこう，^[7]但ただし不ふ太ふと可能かのう具有ぐゆう临床意い义；^[6]但ただし是ぜ，长期使用しよう会かい出で现问题，因いん此不推荐使用しよう。^[6]^[8]^[9]

参考さんこう资料

^ ^1.0 ^1.1 ^1.2 Nicolle LE. Pivmecillinam in the treatment of urinary tract infections. J Antimicrob Chemother. August 2000, 46 (Suppl A): 35–39. PMID 10969050. doi:10.1093/jac/46.suppl_1.35 .
^ Graninger W. Pivmecillinam—therapy of choice for urinary tract infection. Int J Antimicrob Agents. 22. October 2003,. Suppl 2: 73–8. PMID 14527775. doi:10.1016/S0924-8579(03)00235-8.
^ Tanphaichitra D, Srimuang S, Chiaprasittigul P, Menday P, Christensen OE. The combination of pivmecillinam and pivampicillin in the treatment of enteric fever. Infection. 1984, 12 (6): 381–3. PMID 6569851. doi:10.1007/BF01645219.
^ Selexid Tablets. electronic Medicines Compendium. June 5, 2008. ^{[失效しっこう連結れんけつ]} Retrieved on August 31, 2008.
^ Holme E, Greter J, Jacobson CE, et al. Carnitine deficiency induced by pivampicillin and pivmecillinam therapy. Lancet. August 1989, 2 (8661): 469–73. PMID 2570185. doi:10.1016/S0140-6736(89)92086-2.
^ ^6.0 ^6.1 ^6.2 Brass EP. Pivalate-generating prodrugs and carnitine homeostasis in man. Pharmacol Rev. December 2002, 54 (4): 589–98 [2023-03-02]. PMID 12429869. doi:10.1124/pr.54.4.589. （原始げんし内容ないよう存そん档于2019-12-14）.
^ Abrahamsson K, Holme E, Jodal U, Lindstedt S, Nordin I. Effect of short-term treatment with pivalic acid containing antibiotics on serum carnitine concentration—a risk irrespective of age. Biochem. Mol. Med. June 1995, 55 (1): 77–9. PMID 7551831. doi:10.1006/bmme.1995.1036.
^ Holme E, Jodal U, Linstedt S, Nordin I. Effects of pivalic acid-containing prodrugs on carnitine homeostasis and on response to fasting in children. Scand J Clin Lab Invest. September 1992, 52 (5): 361–72. PMID 1514015. doi:10.3109/00365519209088371.
^ Makino Y, Sugiura T, Ito T, Sugiyama N, Koyama N. Carnitine-associated encephalopathy caused by long-term treatment with an antibiotic containing pivalic acid. Pediatrics. September 2007, 120 (3): e739–41. PMID 17724113. doi:10.1542/peds.2007-0339.

Skeletal formula of mecillinam, the active moiety of pivmecillinam

[Nicolle-1] 1.0 ^1.1 ^1.2 Nicolle LE. Pivmecillinam in the treatment of urinary tract infections. J Antimicrob Chemother. August 2000, 46 (Suppl A): 35–39. PMID 10969050. doi:10.1093/jac/46.suppl_1.35 .

[2] Graninger W. Pivmecillinam—therapy of choice for urinary tract infection. Int J Antimicrob Agents. 22. October 2003,. Suppl 2: 73–8. PMID 14527775. doi:10.1016/S0924-8579(03)00235-8.

[3] Tanphaichitra D, Srimuang S, Chiaprasittigul P, Menday P, Christensen OE. The combination of pivmecillinam and pivampicillin in the treatment of enteric fever. Infection. 1984, 12 (6): 381–3. PMID 6569851. doi:10.1007/BF01645219.

[eMC-4] Selexid Tablets. electronic Medicines Compendium. June 5, 2008. ^{[失效しっこう連結れんけつ]} Retrieved on August 31, 2008.

[5] Holme E, Greter J, Jacobson CE, et al. Carnitine deficiency induced by pivampicillin and pivmecillinam therapy. Lancet. August 1989, 2 (8661): 469–73. PMID 2570185. doi:10.1016/S0140-6736(89)92086-2.

[Brass-6] 6.0 ^6.1 ^6.2 Brass EP. Pivalate-generating prodrugs and carnitine homeostasis in man. Pharmacol Rev. December 2002, 54 (4): 589–98 [2023-03-02]. PMID 12429869. doi:10.1124/pr.54.4.589. （原始げんし内容ないよう存そん档于2019-12-14）.

[7] Abrahamsson K, Holme E, Jodal U, Lindstedt S, Nordin I. Effect of short-term treatment with pivalic acid containing antibiotics on serum carnitine concentration—a risk irrespective of age. Biochem. Mol. Med. June 1995, 55 (1): 77–9. PMID 7551831. doi:10.1006/bmme.1995.1036.

[8] Holme E, Jodal U, Linstedt S, Nordin I. Effects of pivalic acid-containing prodrugs on carnitine homeostasis and on response to fasting in children. Scand J Clin Lab Invest. September 1992, 52 (5): 361–72. PMID 1514015. doi:10.3109/00365519209088371.

[9] Makino Y, Sugiura T, Ito T, Sugiyama N, Koyama N. Carnitine-associated encephalopathy caused by long-term treatment with an antibiotic containing pivalic acid. Pediatrics. September 2007, 120 (3): e739–41. PMID 17724113. doi:10.1542/peds.2007-0339.

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