Jump to: navigation, search
Clinical data
Trade namesCoactin, Leo, Selexid, Selexidin
AHFS/Drugs.comInternational Drug Names
  • Appears safe in pregnancy[1]
Routes of
Intravenous, intramuscular
ATC code
Legal status
Legal status
  • AU: S4 (Prescription only)
  • UK: POM (Prescription only)
  • In general: ℞ (Prescription only)
Pharmacokinetic data
Protein binding5 to 10%
MetabolismSome hepatic metabolism
Elimination half-life1 to 3 hours
ExcretionRenal and biliary, mostly unchanged
CAS Number
PubChem CID
E number{{#property:P628}}
ECHA InfoCard{{#property:P2566}}Lua error in Module:EditAtWikidata at line 36: attempt to index field 'wikibase' (a nil value).
Chemical and physical data
Molar mass325.426 g/mol
3D model (JSmol)
 ☒N☑Y (what is this?)  (verify)

WikiDoc Resources for Mecillinam


Most recent articles on Mecillinam

Most cited articles on Mecillinam

Review articles on Mecillinam

Articles on Mecillinam in N Eng J Med, Lancet, BMJ


Powerpoint slides on Mecillinam

Images of Mecillinam

Photos of Mecillinam

Podcasts & MP3s on Mecillinam

Videos on Mecillinam

Evidence Based Medicine

Cochrane Collaboration on Mecillinam

Bandolier on Mecillinam

TRIP on Mecillinam

Clinical Trials

Ongoing Trials on Mecillinam at Clinical

Trial results on Mecillinam

Clinical Trials on Mecillinam at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Mecillinam

NICE Guidance on Mecillinam


FDA on Mecillinam

CDC on Mecillinam


Books on Mecillinam


Mecillinam in the news

Be alerted to news on Mecillinam

News trends on Mecillinam


Blogs on Mecillinam


Definitions of Mecillinam

Patient Resources / Community

Patient resources on Mecillinam

Discussion groups on Mecillinam

Patient Handouts on Mecillinam

Directions to Hospitals Treating Mecillinam

Risk calculators and risk factors for Mecillinam

Healthcare Provider Resources

Symptoms of Mecillinam

Causes & Risk Factors for Mecillinam

Diagnostic studies for Mecillinam

Treatment of Mecillinam

Continuing Medical Education (CME)

CME Programs on Mecillinam


Mecillinam en Espanol

Mecillinam en Francais


Mecillinam in the Marketplace

Patents on Mecillinam

Experimental / Informatics

List of terms related to Mecillinam

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Mecillinam (INN) or amdinocillin (USAN) is an extended-spectrum penicillin antibiotic that binds specifically to penicillin binding protein 2 (PBP2),[2] and is only considered to be active against Gram-negative bacteria. It is used primarily in the treatment of urinary tract infections, and has also been used to treat typhoid and paratyphoid fever.[3][4] Because mecillinam has very low oral bioavailability, an orally active prodrug was developed: pivmecillinam. Neither drug is available in the United States.[5]

Medical uses

Mecillinam is used in the treatment of infections due to susceptible gram-negative bacteria, especially urinary tract infections which are most commonly caused by Escherichia coli.[6] Mecillinam is active against most pathogenic Gram-negative bacteria, except Pseudomonas aeruginosa and some species of Proteus.[5] Several studies have also found it to be as effective as other antibiotics for treating Staphylococcus saprophyticus infection, though it is Gram-positive, possibly because mecillinam reaches very high concentrations in urine.[1]

Worldwide resistance to mecillinam in bacteria causing urinary tract infection has remained very low since its introduction; a 2003 study conducted in 16 European countries and Canada found resistance to range from 1.2% (Escherichia coli) to 5.2% (Proteus mirabilis).[7] Another large study conducted in Europe and Brazil obtained similar results — 95.9% of E. coli strains, for instance, were sensitive to mecillinam.[8]

Adverse effects

The adverse effect profile of mecillinam is similar to that of other penicillins.[2] Its most common side effects are rash and gastrointestinal upset, including nausea and vomiting.[1]


With the codename FL 1060, mecillinam was developed by the Danish pharmaceutical company Leo Pharmaceutical Products (now LEO Pharma). It was first described in the scientific literature in a 1972 paper.[9][10]


  1. 1.0 1.1 1.2 Nicolle LE (August 2000). = long&pmid = 10969050 "Pivmecillinam in the treatment of urinary tract infections" Check |url= value (help). J Antimicrob Chemother. 46 (Suppl A): 35–39. doi:10.1093/jac/46.suppl_1.35. PMID 10969050.
  2. 2.0 2.1 Neu HC (1985). "Amdinocillin: a novel penicillin. Antibacterial activity, pharmacology and clinical use". Pharmacotherapy. 5 (1): 1–10. PMID 3885172.
  3. Clarke PD, Geddes AM, McGhie D, Wall JC (July 1976). "Mecillinam: a new antibiotic for enteric fever". Br Med J. 2 (6026): 14–5. doi:10.1136/bmj.2.6026.14. PMC 1687648. PMID 820402.
  4. Geddes AM, Clarke PD (July 1977). "The treatment of enteric fever with mecillinam". J Antimicrob Chemother. 3 Suppl B: 101–2. doi:10.1093/jac/3.suppl_b.101. PMID 408321.
  5. 5.0 5.1 Pham P, Bartlett JG (August 28, 2008). "Amdinocillin (Mecillinam)". Point-of-Care Information Technology ABX Guide. Johns Hopkins University. Retrieved on August 31, 2008. Freely available with registration.
  6. Wagenlehner, FME; Schmiemann, G; Hoyme, U; Fünfstück, R; Hummers-Pradier, E; Kaase, M; Kniehl, E; Selbach, I; Sester, U; Vahlensieck, W; Watermann, D; Naber, KG (12 February 2011). "Nationale S3-Leitlinie „Unkomplizierte Harnwegsinfektionen"". Der Urologe (in German). 50 (2): 153–169. doi:10.1007/s00120-011-2512-z. PMID 21312083. Unknown parameter |trans_title= ignored (help)
  7. Kahlmeter G (January 2003). "An international survey of the antimicrobial susceptibility of pathogens from uncomplicated urinary tract infections: the ECO·SENS Project". J Antimicrob Chemother. 51 (1): 69–76. doi:10.1093/jac/dkg028. PMID 12493789.
  8. Naber KG, Schito G, Botto H, Palou J, Mazzei T (May 2008). "Surveillance Study in Europe and Brazil on Clinical Aspects and Antimicrobial Resistance Epidemiology in Females with Cystitis (ARESC): Implications for Empiric Therapy". Eur Urol. 54 (5): 1164–75. doi:10.1016/j.eururo.2008.05.010. PMID 18511178.
  9. Lund F, Tybring L (April 1972). "6β-amidinopenicillanic acids—a new group of antibiotics". Nature New Biol. 236 (66): 135–7. doi:10.1038/236135c0. PMID 4402006.
  10. Tybring L, Melchior NH (September 1975). "Mecillinam (FL 1060), a 6β-Amidinopenicillanic Acid Derivative: Bactericidal Action and Synergy In Vitro". Antimicrob Agents Chemother. 8 (3): 271–6. doi:10.1128/aac.8.3.271. PMC 429305. PMID 170856.