Effect of Short-Term Treatment with Pivalic Acid Containing Antibiotics on Serum Carnitine Concentration - A Risk Irrespective of Age

Abstract

Treatment with pivalic acid containing prodrugs has been shown to cause carnitine depletion by loss of pivaloyl carnitine in urine. A 7-day standard pivmecillinam treatment of adults lead to a marked decrease of the free serum carnitine concentration (44.6 to 12.9 μmol/liter), whereas no change was seen in those given norfloxacine (40.0 to 40.5 μmol/liter). In some patients irrespective of age the free serum carnitine concentration was decreased to levels (around 10 μmol/liter) at which an impaired ketone-body production may occur. Therefore, there is reason for cautious use of this type of drug irrespective of the age of the patients.