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Moxalactam Therapy for Bacterial Infections
Drew J. Winston, MD;
Ronald W. Busuttil, MD, PhD;
Terrance O. Kurtz, DO;
Lowell S. Young, MD
Arch Intern Med. 1981;141(12):1607-1612.
Abstract
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• Moxalactam, a novel β-lactam antimicrobial agent in which oxygen has replaced sulfur in the six-membered ring of the conventional cephem nucleus, has in vitro activity against almost all commonly isolated bacterial pathogens including Staphylococcus aureus, the Enterobacteriaceae, Pseudomonas aeruginosa, Bacteroides fragilis, and Haemophilus influenzae. The clinical efficacy and toxicity of moxalactam alone was evaluated in the treatment of 100 infections, including 22 septicemias. Thirty-two infections involved P aeruginosa, while organisms resistant to one or more of the currently available cephalosporins or cefoxitin were isolated from cultures in 63 of the cases. The overall clinical response was favorable (infection cured or improved) in 86% of the infections. A child with Klebsiella pneumoniae ventriculitis and meningitis was cured with intravenous moxalactam alone. Six of 14 treatment failures involved P aeruginosa, and P aeruginosa isolates resistant to moxalactam emerged during therapy of 12 infections. Side effects, usually mild diarrhea, occurred in only 8.8% of the patients. Except for some severe P aeruginosa infections outside the urinary tract, moxalactam is effective and safe single-agent therapy for infections caused by susceptible organisms and represents a major advancement in β-lactam antimicrobial therapy.
(Arch Intern Med 1981;141:1607-1612)
Author Affiliations
From the Division of Infectious Diseases, Department of Medicine (Drs Winston, Kurtz, and Young), and the Division of General Surgery, Department of Surgery (Dr Busuttil), Center for the Health Sciences, UCLA.
Footnotes
Accepted for publication Nov 21, 1980.
Read in part before the 20th Interscience Conference on Antimicrobial Agents and Chemotherapy, New Orleans, Sept 23, 1980.
Reprint requests to Division of Infectious Diseases, Department of Medicine, Center for the Health Sciences, University of California, Los Angeles, CA 90024 (Dr Winston).
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