Mecillinam


Full Prescribing Info
Dosage/Direction for Use

Parenteral
Urinary tract infections
Adult: 800 mg every 6-8 hr by IM, slow IV inj or IV infusion. Severe infections: Up to 60 mg/kg/day.
Contraindications
Hypersensitivity to penicillins; porphyria.
Special Precautions
Renal impairment (particularly high doses). Avoid contact as skin sensitisation may occur. Monitor hepatic, renal and haematological status (high doses or prolonged use). Spirochete infections particularly syphilis. Suprainfection with penicillin-resistant organisms may occur with prolonged use. Avoid intrathecal route.
Adverse Reactions
Hypersensitivity reactions including angioedema, urticaria, rash, serum sickness-like reactions, haemolytic anemia; nephropathy and interstitial nephritis; neutropenia, thrombocytopenia; CNS toxicity including convulsions; diarrhoea, nausea, antibiotic-associated colitis.
Potentially Fatal: Anaphylaxis.
Drug Interactions
Prolonged half-life with probenecid. Antagonism with bacteriostatic drugs e.g. chloramphenicol, tetracyclines. May prolong bleeding time when used with anticoagulants.
Lab Interference
May interfere with diagnostic tests for urinary glucose using copper sulfate, direct Coombs' test and test for urinary or serum proteins. May interfere with diagnostic tests that use bacteria.
Action
Mecillinam, a semisynthetic penicillin, interferes with bacterial cell wall synthesis. It is active against gram-negative bacteria e.g. E. coli, Enterobacter, Klebsiella, Salmonella and Shigella spp. Susceptibility of Proteus spp varies. Serratia marcescens is resistant. It is less active against Neisseria spp and H. influenzae. P. aeruginosa and Bacteroides spp are resistant. It is much less active against gram-positive bacteria; enterococci including E. faecalis are resistant. It is inactivated by β-lactamases, but is more stable than ampicillin.
Absorption: Poorly absorbed from the GI tract; peak plasma concentrations after 30 min (IM).
Distribution: Protein-binding: 5-10%. Widely distributed in body tissues and fluids; small amounts enter into the CSF; crosses the placenta and distributes into breast milk
Metabolism: Limited metabolism.
Excretion: Via urine (50-70% of parenteral dose) by glomerular filtration and tubular secretion; via bile. Plasma half-life: About 1 hr; ≥3-5 hr in severe renal impairment.
CIMS Class
ATC Classification
J01CA11 - mecillinam ; Belongs to the class of penicillins with extended spectrum. Used in the systemic treatment of infections.
Disclaimer: This information is independently developed by CIMS based on mecillinam from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 CIMS. All rights reserved. Powered by CIMSAsia.com
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