{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:24:05Z","timestamp":1777922645049,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2012,4,1]],"date-time":"2012-04-01T00:00:00Z","timestamp":1333238400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2012,4]]},"abstract":"\n To evaluate the clinical and bacteriological efficacy of pivmecillinam against lower urinary tract infection (UTI) caused by extended-spectrum \u03b2-lactamase (ESBL)-producing\n Escherichia coli<\/jats:italic>\n and\n Klebsiella pneumoniae<\/jats:italic>\n , patients treated for lower UTI with pivmecillinam (\n n<\/jats:italic>\n =8) were studied. Patients treated with nitrofurantoin (\n n<\/jats:italic>\n =3) and trimethoprim (\n n<\/jats:italic>\n =3) or a combination of these agents with pivmecillinam (\n n<\/jats:italic>\n =3) were included as a control group. Antimicrobial susceptibility was determined with EUCAST methodology. Bacteriologic cure was defined as <10\n 3<\/jats:sup>\n CFU\/ml at follow-up (30 days), and clinical cure as resolved UTI symptoms after completed treatment. All patients receiving pivmecillinam had good clinical response (8\/8), but bacteriological cure rates were low (2\/8). However, none of the patients with persisting bacteriuria had a relapse of UTI symptoms within 6 months. All isolates were susceptible to the given antimicrobial. Most isolates belonged to the CTX-M-1 group (\n n<\/jats:italic>\n =11, 65%) or CTX-M-9-group (\n n<\/jats:italic>\n =4, 24%). Four\n E. coli<\/jats:italic>\n isolates belonged to the international clone O25b-ST131 (25%). In conclusion, pivmecillinam had good clinical activity against lower UTI caused by ESBL-producing Enterobacteriaceae, but bacteriological cure rates were low. The persistent bacteriuria appears to be of little clinical importance, but larger clinical studies are needed to determine the usefulness of pivmecillinam in infections caused by ESBL-producing bacteria.\n <\/jats:p>","DOI":"10.1089\/mdr.2011.0161","type":"journal-article","created":{"date-parts":[[2011,12,28]],"date-time":"2011-12-28T09:08:10Z","timestamp":1325063290000},"page":"189-192","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":34,"title":["Efficacy of Pivmecillinam for Treatment of Lower Urinary Tract Infection Caused by Extended-Spectrum \u03b2-Lactamase\u2013Producing\n Escherichia coli<\/i>\n and\n Klebsiella pneumoniae<\/i>"],"prefix":"10.1177","volume":"18","author":[{"given":"Emilia","family":"Titelman","sequence":"first","affiliation":[{"name":"Karolinska University Hospital","place":["Sweden"]},{"name":"Karolinska University Hospital","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aina","family":"Iversen","sequence":"additional","affiliation":[{"name":"Karolinska University Hospital","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mats","family":"Kalin","sequence":"additional","affiliation":[{"name":"Karolinska University Hospital","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian G.","family":"Giske","sequence":"additional","affiliation":[{"name":"Karolinska University Hospital","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2012,4]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1099\/jmm.0.46909-0","article-title":"Real-time TaqMan PCR for rapid detection and typing of genes encoding CTX-M extended-spectrum beta-lactamases","volume":"56","author":"Birkett C.I.","year":"2007","unstructured":"Birkett C.I., , Ludlam H.A., , Woodford N. et al. 2007. Real-time TaqMan PCR for rapid detection and typing of genes encoding CTX-M extended-spectrum beta-lactamases. J. Med. Microbiol., 56:52\u201355.","journal-title":"J. Med. Microbiol."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkp194"},{"key":"e_1_3_3_4_2","unstructured":"European Committee on Antimicrobial Susceptibility Testing (EUCAST). Disk Diffusion Test. www.eucast.org\/eucast_disk_diffusion_test\/. 2011 December 14."},{"issue":"1","key":"e_1_3_3_5_2","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1111\/j.1469-0691.2007.01852.x","article-title":"Other antimicrobials of interest in the era of extended-spectrum beta-lactamases: fosfomycin, nitrofurantoin and tigecycline","volume":"14","author":"Garau J.","year":"2008","unstructured":"Garau J. 2008. Other antimicrobials of interest in the era of extended-spectrum beta-lactamases: fosfomycin, nitrofurantoin and tigecycline. Clin. Microbiol. Infect., 14,Suppl 1:198\u2013202.","journal-title":"Clin. Microbiol. Infect."},{"key":"e_1_3_3_6_2","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1093\/cid\/ciq257","article-title":"International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases","volume":"52","author":"Gupta K.","year":"2010","unstructured":"Gupta K., , Hooton T.M., , Naber K.G. et al. 2010. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin. Infect. Dis., 52:103\u2013120.","journal-title":"Clin. Infect. Dis."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0891-5520(05)70373-1"},{"issue":"1","key":"e_1_3_3_8_2","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1093\/jac\/46.suppl_1.35","article-title":"Pivmecillinam in the treatment of urinary tract infections","volume":"46","author":"Nicolle L.E.","year":"2000","unstructured":"Nicolle L.E. 2000. Pivmecillinam in the treatment of urinary tract infections. J. Antimicrob. Chemother., 46,Suppl 1:35\u201339discussion 63\u201365.","journal-title":"J. Antimicrob. Chemother."},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1080\/00365540701367801"},{"key":"e_1_3_3_10_2","doi-asserted-by":"crossref","first-page":"313","DOI":"10.2165\/11533040-000000000-00000","article-title":"Infections with extended-spectrum beta-lactamase-producing enterobacteriaceae: changing epidemiology and drug treatment choices","volume":"70","author":"Pitout J.D.","year":"2007","unstructured":"Pitout J.D. 2007. Infections with extended-spectrum beta-lactamase-producing enterobacteriaceae: changing epidemiology and drug treatment choices. Drugs, 70:313\u2013333.","journal-title":"Drugs"},{"key":"e_1_3_3_11_2","unstructured":"Svenska infektionsl\u00e4karf\u00f6reningen. V\u00e5rdprogram f\u00f6r behandling av urinv\u00e4gsinfektioner hos vuxna 2006. www.infektion.net\/klinik\/urinvagar\/vardprogram_uvi. 2011 December 14(in Swedish)."},{"key":"e_1_3_3_12_2","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1111\/j.1600-0463.2011.02766.x","article-title":"Antimicrobial susceptibility to parenteral and oral agents in a largely polyclonal collection of CTX-M-14 and CTX-M-15-producing Escherichia coli and Klebsiella pneumoniae","volume":"119","author":"Titelman E.","year":"2011","unstructured":"Titelman E., , Iversen A., , Kahlmeter G. et al. 2011. Antimicrobial susceptibility to parenteral and oral agents in a largely polyclonal collection of CTX-M-14 and CTX-M-15-producing Escherichia coli and Klebsiella pneumoniae. APMIS, 119:853\u2013863.","journal-title":"APMIS"},{"key":"e_1_3_3_13_2","first-page":"CD007182","article-title":"Antimicrobial agents for treating uncomplicated urinary tract infection in women","author":"Zalmanovici Trestioreanu A.","year":"2010","unstructured":"Zalmanovici Trestioreanu A., , Green H., , Paul M. et al. 2010. Antimicrobial agents for treating uncomplicated urinary tract infection in women. Cochrane Database Syst. Rev., CD007182.","journal-title":"Cochrane Database Syst. 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