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Within the penicillin class, pivmecillinam is considered the first-line empiric treatment for acute cystitis due to its wide spectrum of activity against gram-negative bacteria and its specific efficacy in the urinary tract. It has consistently demonstrated a high cure rate of over 85% for UTIs and a low resistance rate among E. coli strains.
Penicillin resistance in Staphylococcus aureus [3] appeared very soon after penicillin entered general clinical use in 1943, and the mechanism of resistance was the production of β-lactamase. Modification of the penicillin molecule so that it was resistant to being broken down by β-lactamase was able to temporarily overcome this problem.
Penicillin is actively excreted, and about 80% of a penicillin dose is cleared from the body within three to four hours of administration. Indeed, during the early penicillin era, the drug was so scarce and so highly valued that it became common to collect the urine from patients being treated, so that the penicillin in the urine could be ...
β-Lactam antibiotics are indicated for the prevention and treatment of bacterial infections caused by susceptible organisms. At first, β-lactam antibiotics were mainly active only against gram-positive bacteria, yet the recent development of broad-spectrum β-lactam antibiotics active against various gram-negative organisms has increased their usefulness.
Antibiotics with less reliable but occasional (depending on isolate and subspecies) activity: occasionally penicillins including penicillin, ampicillin and ampicillin-sulbactam, amoxicillin and amoxicillin-clavulnate, and piperacillin-tazobactam (not all vancomycin-resistant Enterococcus isolates are resistant to penicillin and ampicillin)
The β-lactam core structures. (A) A penam.(B) A carbapenam.(C) An oxapenam.(D) A penem.(E) A carbapenem.(F) A monobactam.(G) A cephem.(H) A carbacephem.(I) An oxacephem. This is a list of common β-lactam antibiotics—both administered drugs and those not in clinical use—organized by structural class.