Carnitine deficiency associated with long-term pivampicillin treatment: the effect of a replacement therapy regime.

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Rose SJ, Stokes TC, Patel S, Cooper MB, Betteridge DJ, Payne JE

Carnitine deficiency associated with long-term pivampicillin treatment: the effect of a replacement therapy regime.

Postgrad Med J. 1992 Nov;68(805):932-4.

PubMed ID

1494519 [ View in PubMed

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Abstract

A 51 year old female developed a skeletal muscle myopathy after 3 months of pivampicillin therapy. Pivampicillin can cause carnitine deficiency due to the pivalic acid side group. Plasma carnitine content and the patients symptoms failed to improve significantly on discontinuing the drug. Oral carnitine replacement therapy was administered for 6 weeks but the patient's plasma carnitine levels responded only slowly to this treatment. It is suggested that pivampicillin inhibits uptake of carnitine from the gut and may either directly or indirectly depress endogenous carnitine synthesis. In such cases a more aggressive carnitine replacement regime is indicated and pivampicillin should be avoided in patients requiring long-term antibiotic administration.

DrugBank Data that Cites this Article

Pharmaco-metabolomics

Drug	Drug Groups	Metabolite	Change	Description
Pivampicillin	Approved	Free carnitine	decreased	Pivampicillin decreases the level of Free carnitine in the blood
Pivampicillin	Approved	Long-chain acylcarnitines	decreased	Pivampicillin decreases the level of Long-chain acylcarnitines in the blood
Pivampicillin	Approved	3-hydroxybutyrate	decreased	Pivampicillin decreases the level of 3-hydroxybutyrate in the blood
Pivampicillin	Approved	Acid-soluble acylcarnitine	increased	Pivampicillin increases the level of Acid-soluble acylcarnitine in the blood