Abstract
During pivampicillin (PIVA) administrtion pivalate is liberated from the drug which can form an ester with Coenzyme-A and subsequently with carnitine. Primary pivaloylcarnitine loss causes carnitine deficiency and hypoletonemia. No data have been available on the effects of PIVA on the overall metabolism of humans.
In 8 children the based RO increased from 0.8 + 0.01 to 0.97+0.01 (p<0.05) on the 3rd day of PIVA (6 × 500 mg) administration measured by indirect calorimetry. Marked decrease was found in the daily utilization of. (1.2 + 0.17 vs 0.31+0.17 g/kg). While the consumption of carbohydrates increased (4.00+0.50 vs 6.20+0.51). No change was found in utilization of nitrogen compound and the total energy utilized was not affected by the treatment. All of the above parameters showed normalization 3 days after the introduction of supplemental carnitine (3×1g) to the PIVA treatment.
The data show, that the PIVA treatment causes profound changes in metabolie fuel consumption, the inhibited fat oxidation was replaced by increased utilization of carbohydrates. Administration of carnitine can reverse these changes by aiding the elimination of pivalate.
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Melegh, B., Molnar, D., Mass, G. et al. EFFECT OF PIVAMPICILLIN TREATMENT ON METABOLIC FGFI CONSUMPTION. Pediatr Res 35, 284 (1994). https://doi.org/10.1203/00006450-199402000-00176
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DOI: https://doi.org/10.1203/00006450-199402000-00176