The Effect of Food on the Absorption of Pivampicillin and a Comparison with the Absorption of Ampicillin Potassium

Abstract

The effect of food on the absorption of pivampicillin hydrochloride and ampicillin potassium was compared in a single-dose, 3-way, cross-over study in fifteen healthy adult subjects. The antibiotics were given in their recommended doses in capsule form: 350 mg of pivampicillin and 500 mg of ampicillin. Ampicillin was administered in the fasting state while pivampicillin was administered both in the fasting state and during a standardized cooked breakfast. The presence of food caused a substantial decrease and delay in the absorption of pivampicillin. Pivampicillin administered during a meal, as recommended to minimize gastro-intestinal irritation, resulted in lower serum levels than those attained with ampicillin given without food. The average peak serum levels of pivampicillin taken during meals was 3.34 mcg/ml compared to 4.47 mcg/ml with ampicillin given in the fasting state. The total antibiotic coverage indicated by time-absorption curves was also considerably lower with pivampicillin than with ampicillin under conditions simulating those recommended during clinical use by the respective manufacturers.