Slow replenishment of carnitine deficiency after cessation of long-term treatment with pivaloyl-containing antibiotics

Long-term treatment with pivampicillin and pivmecillinam for 6-24 months in five adults and one child reduced the total serum carnitine concentration to 3.7-14 mumol/l (reference value: 25-66 mumol/l). Muscle carnitine was reduced to 0.3-0.7 mumol/g wet weight (reference value: 3-5 mumol/g) in two c...

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Published inPharmacy world and science Vol. 15; no. 5; p. 225
Main Authors Diep, Q N, Bøhmer, T, Holme, J I, Torvik, A, Storrøsten, O T, Loennecken, C W, Monstad, P, Jellum, E
Format Journal Article
LanguageEnglish
Published Germany 15.10.1993
Subjects
Adult
Aged
Aged, 80 and over
Amdinocillin Pivoxil - adverse effects
Carnitine - blood
Carnitine - deficiency
Child
Female
Humans
Male
Pivampicillin - adverse effects
Time Factors
Vitamin B Deficiency - blood
Vitamin B Deficiency - chemically induced
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Summary:Long-term treatment with pivampicillin and pivmecillinam for 6-24 months in five adults and one child reduced the total serum carnitine concentration to 3.7-14 mumol/l (reference value: 25-66 mumol/l). Muscle carnitine was reduced to 0.3-0.7 mumol/g wet weight (reference value: 3-5 mumol/g) in two cases. All patients had muscle symptoms with weakness, asthenia and pains. One showed signs of carnitine depletion in the liver with increased secretion of dicarboxylic acids (C6, C8, C10) in urine and limited ketone body formation during prolonged fasting. Serum carnitine increased slowly after cessation of therapy and reached normal concentrations after 6-12 months. All symptoms caused by carnitine depletion disappeared. This was achieved on a normal diet without carnitine supplementation.
ISSN:0928-1231
DOI:10.1007/BF01880631