pivmecillinam pivmecillinam pivmecillinam (inn) or amdinocillin pivoxil (usan, trade names selexid, penomax and coactabs) is an orally active prodrug of mecillinam, an extended-spectrum penicillin antibiotic. pivmecillinam is the pivaloyloxymethyl ester of mecillinam. pivmecillinamclinical dataahfs/drugs.commicromedex detailed consumer informationpregnancycategory appears safe in pregnancy routes ofadministrationoralatc codej01ca08 (who) legal statuslegal status in general: ℞ (prescription only) pharmacokinetic databioavailabilitylowprotein binding5 to 10% (as mecillinam)metabolismpivmecillinam is hydrolyzed to mecillinamelimination half-life1 to 3 hoursexcretionrenal and biliary, mostly as mecillinamidentifiers iupac name 2,2-dimethylpropanoyloxymethyl (2s,5r,6r)-6--3,3-dimethyl-7-oxo-4-thia-1-azabicycloheptane-2-carboxylate cas number32886-97-8 ypubchem cid36272chemspider33356 nunii1wam1oq30bkeggd02889 ychemblchembl1650818 ncomptox dashboard (epa)dtxsid7048538 echa infocard100.046.600 chemical and physical dataformulac21h33n3o5smolar mass439.57 g·mol−13d model (jsmol)interactive image smiles cc1(c(n2c(s1)c(c2=o)n=cn3cccccc3)c(=o)ococ(=o)c(c)(c)c)c ny (what is this?) (verify) pivmecillinam is only considered to be active against gram-negative bacteria, and is used primarily in the treatment of lower urinary tract infections. in the nordic countries, it has been widely used in that indication since the 1970s. it has been proposed as the first-line drug of choice for empirical treatment of acute cystitis. it has also been used to treat paratyphoid fever and shigellosis. activity