Pipemidic acid
An article about the antibiotic pipemidic acid
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Pipemidic acid is a quinolone antibiotic used primarily in the treatment of urinary tract infections. It belongs to the class of first-generation quinolones and is known for its activity against a range of Gram-negative bacteria.
Chemical structure and properties
Pipemidic acid is a pyridopyrimidine derivative with a chemical structure that includes a piperazine ring. This structure is crucial for its antibacterial activity, allowing it to inhibit bacterial DNA gyrase, an enzyme essential for DNA replication in bacteria.
Mechanism of action
Pipemidic acid works by interfering with the DNA replication process of bacteria. It targets the DNA gyrase enzyme, which is responsible for supercoiling the DNA. By inhibiting this enzyme, pipemidic acid prevents the bacteria from replicating and repairing their DNA, leading to bacterial cell death.
Clinical uses
Pipemidic acid is primarily used to treat urinary tract infections caused by susceptible strains of bacteria. It is effective against a variety of Gram-negative bacteria, including Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis. However, it is not effective against Gram-positive bacteria or anaerobic bacteria.
Side effects
Common side effects of pipemidic acid include gastrointestinal disturbances such as nausea, vomiting, and diarrhea. Some patients may experience allergic reactions, including rash and pruritus. Rarely, it can cause central nervous system effects such as dizziness and headache.
Pharmacokinetics
Pipemidic acid is well absorbed from the gastrointestinal tract and reaches peak plasma concentrations within 1 to 2 hours after oral administration. It is primarily excreted unchanged in the urine, which makes it particularly effective for treating urinary tract infections.
Resistance
Bacterial resistance to pipemidic acid can occur through mutations in the DNA gyrase gene or through the acquisition of plasmid-mediated resistance mechanisms. Resistance is more common in areas with high usage of quinolone antibiotics.
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