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STEPS
New Drug Reviews

Pivmecillinam (Pivya) for Uncomplicated Urinary Tract Infections in Female Patients

Sara Diletti-Swenson, MD
Emily Feng, MD

American Family Physician. 2026;113(5):504-505.

Author disclosure: No relevant financial relationships.

SARA DILETTI-SWENSON, MD, and EMILY FENG, MD, Tufts University School of Medicine, Boston, Massachusetts

Address correspondence to Sara Diletti-Swenson, MD, at sdilettiswenson@challiance.org.

Author disclosure: No relevant financial relationships.

  1. 1.US Food and Drug Administration. Pivya (pivmecillinam) tablets, for oral use [package insert]. April 2024. Accessed April 28, 2025. https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/216483s000lbl.pdf
  2. 2.Bjerrum L, Gahrn-Hansen B, Grinsted P. Pivmecillinam versus sulfamethizole for short-term treatment of uncomplicated acute cystitis in general practice: a randomized controlled trial. Scand J Prim Health Care. 2009;27(1):6-11.
  3. 3.Vik I, Bollestad M, Grude N, et al. Ibuprofen versus pivmecillinam for uncomplicated urinary tract infection in women—a double-blind, randomized non-inferiority trial. PLoS Med. 2018;15(5):e1002569.
  4. 4.Menday AP. Comparison of pivmecillinam and cephalexin in acute uncomplicated urinary tract infection. Int J Antimicrob Agents. 2000;13(3):183-187.
  5. 5.Ferry SA, Holm SE, Stenlund H, et al. Clinical and bacteriological outcome of different doses and duration of pivmecillinam compared with placebo therapy of uncomplicated lower urinary tract infection in women: the LUTIW project. Scand J Prim Health Care. 2007;25(1):49-57.

STEPS new drug reviews cover Safety, Tolerability, Effectiveness, Price, and Simplicity. Each independent review is provided by authors who have no financial association with the drug manufacturer.

This series is coordinated by Allen F. Shaughnessy, PharmD, assistant medical editor.

A collection of STEPS published in AFP is available at https://www.aafp.org/afp/steps.

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COVID-19 Vaccines Are Still Effective at Reducing Emergency Department Visits, Hospitalizations, and Especially Mortality
May 2026
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