Effect of short-term treatment with pivalic acid containing antibiotics on serum carnitine concentration--a risk irrespective of age.
Treatment with pivalic acid containing prodrugs has been shown to cause carnitine depletion by loss of pivaloyl carnitine in urine. A 7-day standard pivmecillinam treatment of adults lead to a marked decrease of the free serum carnitine concentration (44.6 to 12.9 mumol/liter), whereas no change was seen in those given norfloxacine (40.0 to 40.5 mumol/liter). In some patients irrespective of age the free serum carnitine concentration was decreased to levels (around 10 mumol/liter) at which an impaired ketone-body production may occur. Therefore, there is reason for cautious use of this type of drug irrespective of the age of the patients.
Abrahamsson
K
K
Department of Pediatrics, Gothenburg University, Gothenburg, Sweden.
Holme
E
E
Jodal
U
U
Lindstedt
S
S
Nordin
I
I
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000561:Amdinocillin Pivoxil / Q000008:administration & dosage / Q000009:adverse effects*; D002331:Carnitine / Q000097:blood* / Q000172:deficiency; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009643:Norfloxacin / Q000008:administration & dosage; D010406:Penicillins / Q000008:administration & dosage / Q000009:adverse effects*; D010421:Pentanoic Acids / Q000008:administration & dosage / Q000009:adverse effects*; D011355:Prodrugs / Q000008:administration & dosage / Q000009:adverse effects; D012307:Risk Factors; D013997:Time Factors; D014552:Urinary Tract Infections / Q000188:drug therapy
D010406:Penicillins; D010421:Pentanoic Acids; D011355:Prodrugs; D000561:Amdinocillin Pivoxil; C005566:pivalic acid; D009643:Norfloxacin; D002331:Carnitine