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Drugs Oct 1983Moxalactam (latamoxef) is a new synthetic oxa-beta-lactam antibiotic administered intravenously or intramuscularly. It has a broad spectrum of activity against... (Review)
Review
Moxalactam (latamoxef) is a new synthetic oxa-beta-lactam antibiotic administered intravenously or intramuscularly. It has a broad spectrum of activity against Gram-positive and Gram-negative aerobic and anaerobic bacteria, is particularly active against Enterobacteriaceae and is resistant to hydrolysis by beta-lactamases. Moxalactam has moderate activity against Pseudomonas aeruginosa, but on the basis of present evidence can not be recommended as sole antibiotic treatment of known or suspected pseudomonal infections. Like the related compounds, the cephalosporins, moxalactam is effective in the treatment of complicated urinary tract infections and lower respiratory tract infections caused by Gram-negative bacilli. As moxalactam is also active against Bacteroides fragilis it has considerable potential in the treatment of intra-abdominal infections in patients with normal immunological mechanisms, as well as in immunocompromised patients, when used alone or in combination with other antibiotics. Likewise, its ready penetration into the diseased central nervous system, its high level of activity against Gram-negative bacilli, and the lack of necessity to monitor drug plasma concentrations, indicate its potential value in the treatment of neonatal Gram-negative bacillary meningitis. Further clinical experience is needed before it can be determined whether moxalactam alone can be used in the treatment of conditions for which the aminoglycosides are drugs of choice, but if established as equally effective, moxalactam has the advantage of being devoid of nephrotoxicity. Bleeding is a potentially serious problem, however, particularly in the elderly, malnourished and in the presence of renal impairment.
Topics: Absorption; Adult; Aminoglycosides; Bacteria, Anaerobic; Central Nervous System Diseases; Child; Dose-Response Relationship, Drug; Drug Resistance, Microbial; Drug Synergism; Enterobacteriaceae; Female; Genital Diseases, Female; Humans; Infant, Newborn; Inflammation; Kidney Diseases; Kinetics; Male; Moxalactam; Respiratory Tract Infections; Sepsis; Staphylococcus; Streptococcus; Tissue Distribution; Urinary Tract Infections
PubMed: 6354685
DOI: 10.2165/00003495-198326040-00001 -
Archives of Surgery (Chicago, Ill. :... Jun 1988One hundred five patients with peritonitis were randomized to receive either tobramycin sulfate plus clindamycin phosphate or moxalactam alone before surgical... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial Review
One hundred five patients with peritonitis were randomized to receive either tobramycin sulfate plus clindamycin phosphate or moxalactam alone before surgical intervention. Fifty-nine patients were evaluable. A mean of 3.1 (moxalactam) and 3.5 (tobramycin-clindamycin) pathogens per patient were identified. Overall success rate was 85% (tobramycin-clindamycin, 24/30; moxalactam, 26/29). When patients with appendicitis were excluded, there was an observed but not statistically significant advantage of moxalactam over tobramycin-clindamycin (85% vs 67%). There were five deaths (tobramycin-clindamycin, four; moxalactam, one). Other complications included hypoprothrombinemia (tobramycin-clindamycin, five; moxalactam, five), renal dysfunction (tobramycin-clindamycin, three; moxalactam, one), and superinfection (tobramycin-clindamycin, nine; moxalactam, six). More wound infections were noted in the group given tobramycin-clindamycin. These data suggest that moxalactam is as safe and efficacious as tobramycin plus clindamycin. The observed benefits of this agent warrant study in a larger sample to verify advantages of moxalactam over combination therapy.
Topics: Abscess; Adolescent; Adult; Bacteroides Infections; Clindamycin; Clinical Trials as Topic; Combined Modality Therapy; Drug Therapy, Combination; Escherichia coli Infections; Humans; Hypoprothrombinemias; Infant, Newborn; Middle Aged; Moxalactam; Peritonitis; Premedication; Prospective Studies; Random Allocation; Sepsis; Streptococcal Infections; Surgical Wound Infection; Tobramycin
PubMed: 3285809
DOI: 10.1001/archsurg.1988.01400300060009 -
Archives of Ophthalmology (Chicago,... Mar 1984Moxalactam disodium is a new third-generation semisynthetic, broad-spectrum, cephalosporin-like antibiotic for parenteral administration. Topical, subconjunctival, and...
Moxalactam disodium is a new third-generation semisynthetic, broad-spectrum, cephalosporin-like antibiotic for parenteral administration. Topical, subconjunctival, and intravenous administration provide poor concentration in the vitreous. To determine its toxicity in intravitreal administration, we injected comparative doses directly into the vitreous cavity of 21 rabbits. With doses of 1.25 mg or less there was no toxic damage to the retina. With a dose of 2.5 mg, early degeneration of photoreceptors was seen after three months. With higher doses (5 and 10 mg) there were major histopathologic and electroretinographic changes. These results suggest the feasibility of employing moxalactam in the treatment of acute, severe, fulminant bacterial endophthalmitis.
Topics: Animals; Bacterial Infections; Electroretinography; Endophthalmitis; Injections; Microscopy, Electron; Mitochondrial Swelling; Moxalactam; Photoreceptor Cells; Rabbits; Retina; Rod Cell Outer Segment; Vitreous Body
PubMed: 6608344
DOI: 10.1001/archopht.1984.01040030349036 -
Revista de Medicina de La Universidad... Mar 1983
Topics: Drug Evaluation; Humans; Kinetics; Moxalactam
PubMed: 6669834
DOI: No ID Found -
Lancet (London, England) Jan 1983
Topics: Cephalosporins; Cephamycins; Humans; International Cooperation; Moxalactam; Pharmacopoeias as Topic; Terminology as Topic
PubMed: 6129432
DOI: 10.1016/s0140-6736(83)91761-0 -
Annals of Internal Medicine Jul 1984
Topics: Aged; Humans; Middle Aged; Moxalactam; Pleural Effusion
PubMed: 6732082
DOI: 10.7326/0003-4819-101-1-144_2 -
Antimicrobial Agents and Chemotherapy Jan 1984The pharmacokinetics of moxalactam were studied in 19 male volunteers 60 years of age or older with normal liver function tests and a creatinine clearance of greater...
The pharmacokinetics of moxalactam were studied in 19 male volunteers 60 years of age or older with normal liver function tests and a creatinine clearance of greater than or equal to 60 ml/min. Moxalactam was administered in single or multiple intravenous or intramuscular doses. Rapid and complete intramuscular bioavailability was demonstrated in a subgroup of the study population. The mean plasma half-life was 2.9 +/- 0.8 h for intravenous doses and 3.5 +/- 0.9 h for intramuscular doses. Average renal clearances of 0.04 liters/kg per h accounted for 74.0 +/- 15.0% of total plasma clearance. Moxalactam plasma clearance showed a statistically significant (P less than 0.01) correlation with measured and calculated creatinine clearance. The major differences in moxalactam pharmacokinetics seen in the elderly appear to be related to diminishing renal function and highly variable nonrenal elimination. Creatinine clearance can be used in estimating moxalactam doses in the elderly without significant renal impairment, but recommendations for the use of serum creatinine as an estimation of renal function or drug half-life are not valid in this population group.
Topics: Aged; Biological Availability; Half-Life; Humans; Injections, Intramuscular; Injections, Intravenous; Kinetics; Male; Middle Aged; Moxalactam
PubMed: 6703682
DOI: 10.1128/AAC.25.1.33 -
Antimicrobial Agents and Chemotherapy Jul 1983The concentrations of moxalactam in human prostatic tissue, obtained by enucleation or transurethral resection, were measured in 10 patients after the intramuscular...
The concentrations of moxalactam in human prostatic tissue, obtained by enucleation or transurethral resection, were measured in 10 patients after the intramuscular administration of two 500-mg doses. The average concentrations of moxalactam in prostatic tissue in the enucleated and transurethral resection specimens were 4.0 micrograms/g and 5.2 micrograms/ml, and the ratios of the moxalactam concentrations in prostate to those in plasma were 0.24 and 0.31, respectively. The concentrations of moxalactam achieved in prostatic tissue after the administration of relatively low doses were greater than the minimum inhibitory concentrations of moxalactam for most common gram-negative pathogens. Concentrations of moxalactam in carefully obtained transurethral resection specimens were similar to those found in the enucleated specimens.
Topics: Aged; Humans; Male; Middle Aged; Moxalactam; Prostate; Prostatectomy
PubMed: 6625553
DOI: 10.1128/AAC.24.1.15 -
Archives of Ophthalmology (Chicago,... Sep 1984
Topics: Animals; Humans; Moxalactam; Rabbits; Vitreous Body
PubMed: 6477239
DOI: 10.1001/archopht.1984.01040031027009 -
Antimicrobial Agents and Chemotherapy Aug 1981The biliary excretion of moxalactam was studied in 11 postsurgery patients who had indwelling T-tubes inserted in their common bile ducts. Peak levels of moxalactam in...
The biliary excretion of moxalactam was studied in 11 postsurgery patients who had indwelling T-tubes inserted in their common bile ducts. Peak levels of moxalactam in the bile reached mean levels of 33.7 +/- 11.1 and 173.7 +/- 67.0 micrograms/ml 2 h after intravenous administration of a single 500- or 2,000-mg dose, respectively. In 5 of the 10 patients given the 2,000-mg dose, peak moxalactam concentrations in the bile were 2 to 12 times higher than simultaneous serum levels, but considerable variation in the biliary excretion of moxalactam was observed among the individual patients.
Topics: Bile; Biological Assay; Cephalosporins; Cephamycins; Humans; Liver; Moxalactam
PubMed: 6456690
DOI: 10.1128/AAC.20.2.231