WHA
 

Pivya (pivmecillinam)

Indications for Prior Authorization

Pivya (pivmecillinam)
  • For diagnosis of Uncomplicated Urinary Tract Infections (uUTI)
    Indicated for the treatment of female patients 18 years of age and older with uncomplicated urinary tract infections (uUTI) caused by susceptible isolates of Escherichia coli (E. coli), Proteus mirabilis, and Staphylococcus saprophyticus.

Criteria

Pivya

Prior Authorization

Length of Approval: 7 Days [A]

  • Diagnosis of uncomplicated urinary tract infection (uUTI)
    • AND
  • Infection susceptible to pivmecillinam
    • AND
  • Patient is 18 years of age or older
    • AND
  • Trial and inadequate response, contraindication or resistance to one alternative oral antibacterial treatment option (e.g., trimethoprim-sulfamethoxazole, ciprofloxacin)
    • AND
  • Infection is caused by one of the following: [B]
    • Escherichia coli
    • Proteus mirabilis
    • Staphylococcus saprophyticus

  • Guideline ID
    GL-520202

  • Formulary
    premium

  • Effective date
    Apr 1, 2026

  • P&T approval date
    Mar 18, 2026

P & T Revisions

1970-01-01

  1. Pivya Prescribing Information. Utility Therapeutics Limited. Florham Park, NJ. April 2024.
  2. UptoDate. Acute simple cystitis in female adults. Available at: https://www.uptodate.com/contents/acute-simple-cystitis-in-female-adults?search=uncomplicated%20urinary%20tract%20infection&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H899949213. Accessed February 10, 2026.
  3. Nelson, Z., Tarık Aslan, A., Beahm, N., et al. Guidelines for the Prevention, Diagnosis, and Management of Urinary Tract Infections in Pediatrics and Adults. Available at: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2825634. accessed February 10, 2026.
  4. Bono, M., and Leslie, S. Uncomplicated Urinary Tract Infections. Available at: https://www.ncbi.nlm.nih.gov/books/NBK470195/. Accessed February 10, 2026.
  5. Ackerman AL, Bradley M, D’Anci KE, Hickling D, Kim SK, Kirkby E. Updates to Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2025). J Urol. 0(0). Available at: https://www.auanet.org/guidelines-and-quality/guidelines/recurrent-uti. Accessed February 10, 2026.
  1. The recommended dosage of Pivya is one 185 mg tablet orally 3 times a day for 3 to 7 days as clinically indicated. [1]
  2. To reduce the development of drug-resistant bacteria and maintain the effectiveness of Pivya and other antibacterial drugs, Pivya should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. [1]