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AMR Drug RepurposingSmart Screeningresearch prototype

Amdinocillin

FDA-approved product (injectable, injection), marketed as Coactin.

Registered studies
11
Lab records
12
Pathogens at ≥40%
2 of 4

Chemical structure

Chemical structure of Amdinocillin
A drawing shows what the molecule is, not what it does.

Existing / approved use

Documented · FDA, WHO, ChEMBL

Approved for

  • Bacterial disease

Indications ChEMBL records as approved, from FDA and DailyMed labels.

WHO therapeutic group
Penicillins with extended spectrum
Anti-infective classification
Classified as an existing antimicrobial.WHO ATC J01CA11

Repurposing investigation

Amdinocillin is already an antimicrobial, so it is not counted among the repurposing candidates. Its AI-predicted activity is shown below for reference.

AI-predicted activity

AI prediction · nothing measured
  • MRSA5.5% AI-predicted activityBelow the ≥40% mark this site uses to surface candidates. This medicine was in the model's training data, so this is recall, not a new prediction.
  • E. coli67.8% AI-predicted activityAt or above the ≥40% mark this site uses to surface candidates. This medicine was in the model's training data, so this is recall, not a new prediction.
  • K. pneumoniae74.0% AI-predicted activityAt or above the ≥40% mark this site uses to surface candidates. This medicine was in the model's training data, so this is recall, not a new prediction.
  • M. tuberculosis38.7% AI-predicted activityBelow the ≥40% mark this site uses to surface candidates.

A model’s estimate of laboratory activity against each pathogen species. It is not clinical effectiveness.

Evidence

Clinical and experimental

Documented evidence

Clinical

11registered studies name this medicine, for any condition. See them below.

Experimental

  • MRSA: measured active in 0 of 1 lab record
  • E. coli: measured active in 8 of 8 lab records
  • K. pneumoniae: measured active in 2 of 3 lab records
Open Amdinocillin in ChEMBL Registered studies below
Show the 12 laboratory records, with sources

Loading records…

“Active” means the measured value reached this project’s laboratory cutoff (10 µM or stronger). A laboratory result does not show an effect in patients.

Docking

Computational · nothing measured

Dihydrofolate reductase ↗ (E. coli)

-4.5 kcal/mol

0better fit →-12

KPC-2 carbapenemase ↗ (K. pneumoniae)

-5.7 kcal/mol

0better fit →-12

Enoyl-ACP reductase (InhA) ↗ (M. tuberculosis)

-5.9 kcal/mol

0better fit →-12

Dihydrofolate reductase ↗ (MRSA)

-4.7 kcal/mol

0better fit →-12

AutoDock Vina, one experimentally solved protein per pathogen. This project’s screening target is -7.0 kcal/mol, its own mark rather than a universal cutoff. A docking score is a structural hypothesis, not proof of binding, and requires experimental validation.

Other medicines to investigate

AI prediction · nothing measured

Other repurposing candidates: approved medicines besides Amdinocillin with AI-predicted activity ≥40% against the chosen pathogen, leaving out existing antimicrobials. They are computational candidates for further investigation, not alternatives and not recommendations.

Sorted by AI-predicted activity, high to low. The order is not a ranking of which medicine is better.

Registered studies

A registration describes a study; it does not establish a positive result.

  • Prediction and Prevention of Bloodstream Infections After Kidney Transplantation

    NCT07407673 · start 2027-01-01

    Registered record
    Registry ID
    NCT07407673
    Conditions
    Kidney Transplant Infection; Bloodstream Infection; Kidney Transplant; Kidney Transplant Recipients; Infection; Urinary Tract Infection(UTI); Urinary Tract Infection Bacterial; Antibiotic Prophylaxis; Bacteriuria
    Interventions
    Pivmecillinam; Placebo
    Study type
    INTERVENTIONAL
    Phase
    Phase 3
    Registry status
    Not yet recruiting
    Start
    2027-01-01
    Completion
    2041-07
    Enrolment
    180

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionKidney Transplant Infection; Bloodstream Infection; Kidney Transplant; Kidney Transplant Recipients +5 more
    InterventionPivmecillinam; Placebo
    PhasePhase 3
    Registry statusNot yet recruiting

  • Pivmecillinam as Oral Step-Down Treatment for Escherichia Coli Febrile Urinary Tract Infection Versus Standard of Care

    NCT07236944 · start 2025-12

    Registered record
    Registry ID
    NCT07236944
    Conditions
    Febrile Urinary Tract Infection
    Interventions
    Pivmecillinam; Standard of Care (Investigator Choice)
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Recruiting
    Start
    2025-12
    Completion
    2029-03
    Enrolment
    560

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionFebrile Urinary Tract Infection
    InterventionPivmecillinam; Standard of Care (Investigator Choice)
    PhasePhase 4
    Registry statusRecruiting

  • Clinical Trial Testing Whether Targeted Antibiotic Prophylaxis Can Reduce Infections After Cystectomy Compared to Empiric Prophylaxis

    NCT06709196 · start 2025-01-07

    Registered record
    Registry ID
    NCT06709196
    Conditions
    Cystectomy; Bladder Cancer Requiring Cystectomy; Postoperative Infections; Antibiotic Prophylaxis; Ileal Conduit
    Interventions
    Pivmecillinam; Pivmecillinam; Amoxicillin clavulanic acid; Amoxicillin; Cefuroxime; Ciprofloxacin; Linezolid; Nitrofurantoin; Trimethoprim; Sulfamethoxazole trimethoprim; Fluconazole
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Recruiting
    Start
    2025-01-07
    Completion
    2027-01
    Enrolment
    248

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionCystectomy; Bladder Cancer Requiring Cystectomy; Postoperative Infections; Antibiotic Prophylaxis +1 more
    InterventionPivmecillinam; Pivmecillinam; Amoxicillin clavulanic acid; Amoxicillin +7 more
    PhasePhase 4
    Registry statusRecruiting

  • Pivmecillinam With Amoxicillin/Clavulanic Acid for Step Down Oral Therapy in ESBL UTIs

    NCT05224401 · start 2023-05-29

    Registered record
    Registry ID
    NCT05224401
    Conditions
    Urinary Tract Infections; Bacteremia; Antibiotic Resistant Infection
    Interventions
    Pivmecillinam and amoxicillin/clavulanic acid; Standard treatment, ciprofloxacin, trimethoprim/sulfamethoxazole or ertapenem depending on susceptibility
    Study type
    INTERVENTIONAL
    Phase
    Phase 3
    Registry status
    Recruiting
    Start
    2023-05-29
    Completion
    2027-09-01
    Enrolment
    330

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionUrinary Tract Infections; Bacteremia; Antibiotic Resistant Infection
    InterventionPivmecillinam and amoxicillin/clavulanic acid; Standard treatment, ciprofloxacin, trimethoprim/sulfamethoxazole or ertapenem depending on susceptibility
    PhasePhase 3
    Registry statusRecruiting

  • Clinical Trial of Pivmecillinam Hydrochloride Tablets in the Treatment of Uncomplicated Urinary Tract Infection

    NCT05545137 · start 2022-09-29

    Registered record
    Registry ID
    NCT05545137
    Conditions
    Uncomplicated Urinary Tract Infection
    Interventions
    Pivmecillinam hydrochloride tablets; Fosfomycin Tromethamine Granules
    Study type
    INTERVENTIONAL
    Phase
    Phase 3
    Registry status
    Completed
    Start
    2022-09-29
    Completion
    2024-02-20
    Enrolment
    299

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionUncomplicated Urinary Tract Infection
    InterventionPivmecillinam hydrochloride tablets; Fosfomycin Tromethamine Granules
    PhasePhase 3
    Registry statusCompleted

  • Clinical Effectiveness and Bacteriological Eradication of 4 Short-course Antibiotics for Uncomplicated UTIs in Women.

    NCT04959331 · start 2021-11-02

    Registered record
    Registry ID
    NCT04959331
    Conditions
    Urinary Tract Infections
    Interventions
    Fosfomycin Trometamol Salt; Nitrofurantoin; Pivmecillinam; Fosfomycin Trometamol Salt
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Completed
    Start
    2021-11-02
    Completion
    2024-12-31
    Enrolment
    1,000

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionUrinary Tract Infections
    InterventionFosfomycin Trometamol Salt; Nitrofurantoin; Pivmecillinam; Fosfomycin Trometamol Salt
    PhasePhase 4
    Registry statusCompleted

  • Culture-guided Antimicrobial Prophylaxis in Men Undergoing Prostate Biopsy.

    NCT03228108 · start 2018-04-03

    Registered record
    Registry ID
    NCT03228108
    Conditions
    Complication; Infection; Prostate Cancer
    Interventions
    Ciprofloxacin; Trimethoprim/Sulfamethoxazole; Fosfomycin; Pivmecillinam/augmentin
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Completed
    Start
    2018-04-03
    Completion
    2021-09-26
    Enrolment
    1,538

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionComplication; Infection; Prostate Cancer
    InterventionCiprofloxacin; Trimethoprim/Sulfamethoxazole; Fosfomycin; Pivmecillinam/augmentin
    PhasePhase 4
    Registry statusCompleted

  • Treating Pyelonephritis an Urosepsis With Pivmecillinam

    NCT03282006 · start 2017-09-29

    Registered record
    Registry ID
    NCT03282006
    Conditions
    Pyelonephritis; Urinary Tract Infections
    Interventions
    pivmecillinam
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Completed
    Start
    2017-09-29
    Completion
    2020-04-21
    Enrolment
    53

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionPyelonephritis; Urinary Tract Infections
    Interventionpivmecillinam
    PhasePhase 4
    Registry statusCompleted

  • Point of Care Susceptibility Testing in Primary Care

    NCT02323087 · start 2015-03

    Registered record
    Registry ID
    NCT02323087
    Conditions
    Urinary Tract Infections
    Interventions
    FLEXICULT™ SSI-Urinary Kit; ID FlexicultTM
    Study type
    INTERVENTIONAL
    Phase
    Not applicable
    Registry status
    Completed
    Start
    2015-03
    Completion
    2016-05
    Enrolment
    377

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionUrinary Tract Infections
    InterventionFLEXICULT™ SSI-Urinary Kit; ID FlexicultTM
    PhaseNot applicable
    Registry statusCompleted

  • Mecillinam for Treatment of Genital Chlamydia Infection

    NCT02083276 · start 2014-03

    Registered record
    Registry ID
    NCT02083276
    Conditions
    Chlamydia Trachomatis Infection; Chlamydial Urethritis
    Interventions
    Pivmecillinamhydrochlorid
    Study type
    INTERVENTIONAL
    Phase
    Phase 2
    Registry status
    Terminated
    Start
    2014-03
    Completion
    2015-05
    Enrolment
    20

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionChlamydia Trachomatis Infection; Chlamydial Urethritis
    InterventionPivmecillinamhydrochlorid
    PhasePhase 2
    Registry statusTerminated

  • Ibuprofen Versus Mecillinam for Uncomplicated Cystitis

    NCT01849926 · start 2013-04

    Registered record
    Registry ID
    NCT01849926
    Conditions
    Acute Cystitis (Excl in Pregnancy)
    Interventions
    Ibuprofen; Mecillinam
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Completed
    Start
    2013-04
    Completion
    2016-07
    Enrolment
    383

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionAcute Cystitis (Excl in Pregnancy)
    InterventionIbuprofen; Mecillinam
    PhasePhase 4
    Registry statusCompleted