Cardiac effects of carnitine deficiency induced by antibiotics containing pivalic acid in children

We studied echocardiographically 17 children with depletion of carnitine due to treatment over 1-3 years with antibiotics containing pivalic acid. When the children were depleted of carnitine, the left ventricular posterior wall was significantly thickened in diastole when compared to a reference group. Six months later, after normalisation of the concentrations of carnitine, the left ventricular posterior wall was significantly thinner and did not differ from the reference group. We conclude that drugs containing pivalic acid, when given for several months, decrease the stores of carnitine to levels where cardiac involvement occurs.