The clinical and bacteriological efficacy as well as the tolerance of
mecillinam, a new
beta-lactam antibiotic, administered parenterally in a dose of 40 mg/kg
body weight, was investigated in 21 hospitalized patients with
urinary tract infections or septicaemia. Success, defined as eradication of infecting organisms two to five days
after treatment, was found in eight of 16 patients with
urinary tract infections. Persistence of the original pathogen
after treatment was seen in four patients, all with complicated
urinary tract infection.
Reinfection was seen in two patients, while the results were unevaluable in two cases. The five patients with septicaemia were all cured of their
infection, this result being attributed solely to
mecillinam in two cases, while a combined action of
mecillinam and another
antibiotic produced a cure in the other three cases. Escherichia coli resistant to
mecillinam were isolated from two patients with persistence of
bacteriuria following
mecillinam treatment. Impairment of renal function may have been a contributory factor to the poor treatment response in patients with complicated
urinary tract infection. Inasmuch as no important side-effects were recorded and
mecillinam appears safe in patients with impaired renal and liver function, a higher dose may be indicated in these more complicated cases.