CARNITINE ADMINISTRATION AMELIORATES THE CHANGES IN ENERGY-METABOLISMCAUSED BY SHORT-TERM PIVAMPICILLIN MEDICATION

Ten children receiving pivampicillin for 8 days were studied. On the f irst 4 days the drug was given alone (4 x 500 mg/day), and on the last 4 days in combination with carnitine (4 x 1 g/day). Pivampicillin tre atment was associated with formation and urinary excretion of pivaloyl carnitine and administration of carnitine aided the elimination of piv alate as its carnitine ester. The resting respiratory quotient increas ed from 0.86 +/- 0.01 to 0.96 +/- 0.01 on the 4th day of pivampicillin treatment. A shift was observed in the metabolic fuel consumption: a significant decrease was found in the amount of fats oxidized (0.31 +/ - 0.17 vs 1.27 +/- 0.17 g.kg(-1).24 h(-1)), while the utilization of c arbohydrates increased (6.20 +/- 0.51 vs 4.00 +/- 0.50 g kg(-1).24 h(- 1)). Administration of carnitine decreased the respiratory quotient to 0.90 +/- 0.01 on the 8th day of treatment, consumption of fats increa sed, and the oxidation of carbohydrates decreased. The resting energy expenditure was not affected by the treatment. Conclusion Pivampicilli n treatment results in inhibited oxidation of fats as metabolic fuel. This drug effect was partially reversed by carnitine which promotes th e elimination of the pivaloyl moiety from the body.