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Antimicrobial Agents and Chemotherapy Feb 1981The pharmacokinetics of moxalactam, a new beta-lactam antibiotic with an unusually broad spectrum of activity, were studied in normal volunteers and compared with the... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
The pharmacokinetics of moxalactam, a new beta-lactam antibiotic with an unusually broad spectrum of activity, were studied in normal volunteers and compared with the pharmacokinetics of cefazolin. After a 1,000-mg intramuscular injection of moxalactam, a mean peak serum level of 49 +/- 10 micrograms/ml was achieved at 30 to 60 min which was equivalent to the level achieved with 0.5 g of cefazolin. Serum levels of 4.57 +/- 0.63 micrograms/ml, above the inhibitory levels for most organisms, were present at 8 h. The half-life of moxalactam was 2.3 h. After a 30-min intravenous infusion of 1 g, the serum level of moxalactam was 60 +/- 18.8 micrograms/ml. This compares with a serum level of 70 micrograms/ml obtained with an infusion of 0.5 g of cefazolin. At 6 h, 3.59 +/- 0.68 microgram/ml of moxalactam was present. The half-life of moxalactam was 2.3 h, similar to that of cefazolin. By 1 h after administration, serum levels of moxalactam were higher after intramuscular administration than after intravenous delivery. Urinary recovery of the drug was 76% after intramuscular injection and 74% after intravenous infusion, with the majority of the drug having been excreted in the first 4 h after administration. Urinary recovery of cefazolin was 85%. The pharmacokinetics of moxalactam are similar to those of cefazolin.
Topics: Adult; Cefazolin; Cephalosporins; Cephamycins; Half-Life; Humans; Infusions, Parenteral; Injections, Intramuscular; Kinetics; Male; Moxalactam
PubMed: 6214989
DOI: 10.1128/AAC.19.2.302 -
Antimicrobial Agents and Chemotherapy Nov 1982We studied the activity of azthreonam (SQ 26,776), a novel monocyclic beta-lactam compound, against a variety of clinical isolates. It was more potent than moxalactam,...
We studied the activity of azthreonam (SQ 26,776), a novel monocyclic beta-lactam compound, against a variety of clinical isolates. It was more potent than moxalactam, cefoperazone, cefamandole, cefoxitin, ticarcillin, tobramycin, or amikacin against strains of Klebsiella spp., Serratia spp., and the Proteus group. It was highly effective against Escherichia coli and strains of Salmonella spp. The median minimal inhibitory concentration for all species of Enterobacteriaceae was less than or equal to 2 micrograms/ml. Azthreonam was moderately active against Pseudomonas aeruginosa, including tobramycin-resistant strains, and against Pseudomonas cepacia (median minimal inhibitory concentration, 16 to 32 micrograms/ml), but was weakly active against Pseudomonas maltophilia and strains of Acinetobacter spp. and Achromobacter spp. The drug showed little activity against Staphylococcus aureus, enterococci, and anaerobic bacteria, including Bacteroides fragilis, Clostridium spp., and gram-positive cocci. Like moxalactam and cefoperazone, azthreonam exhibited a considerable inoculum effect with strains of Enterobacter spp. and Pseudomonas spp. Combination with clavulanic acid did not increase the activity of azthreonam against S. aureus but was synergistic for 5 of 15 strains of B. fragilis. Azthreonam is about 50% bound to human serum protein. The selective range of activity of this compound could be of clinical benefit.
Topics: Anti-Bacterial Agents; Aztreonam; Bacteria; Clavulanic Acids; Enterobacteriaceae; Microbial Sensitivity Tests; Pseudomonas
PubMed: 6891198
DOI: 10.1128/AAC.22.5.832 -
Antimicrobial Agents and Chemotherapy Nov 1981A high-performance liquid chromatographic method for the measurement of moxalactam concentrations in serum was modified to permit the simultaneous measurement of both...
A high-performance liquid chromatographic method for the measurement of moxalactam concentrations in serum was modified to permit the simultaneous measurement of both moxalactam and cefazolin. We then studied whether the simultaneous administration of both moxalactam and cefazolin to normal subjects would produce profiles of serum concentration versus time which were the same as those obtained after the administration of each drug individually. Six healthy adults received a 30-min infusion of cefazolin (10 mg/kg), followed in 2 days by the same dose of moxalactam. After 2 days, both antibiotics were administered together. A two-compartment model was found to adequately characterize the data, and the serum concentration curve for each drug when given alone was statistically identical to that obtained after simultaneous administration. Cefazolin was found to produce a significantly greater peak serum concentration (105 +/- 14 versus 81 +/- 21 microgram/ml) and a significantly greater area under the curve (218 +/- 42 versus 157 +/- 19 . microgram h/ml). The terminal half-life of moxalactam was not significantly longer than for cefazolin (2.2 +/- 0.6 versus 2.0 +/- 0.6 h, respectively). The method of simultaneous administration may have distinct advantages over conventional methods for studies of comparative tissue penetration.
Topics: Adult; Cefazolin; Cephalosporins; Cephamycins; Female; Half-Life; Humans; Infusions, Parenteral; Kinetics; Male; Moxalactam
PubMed: 6459759
DOI: 10.1128/AAC.20.5.576 -
Antimicrobial Agents and Chemotherapy Jun 1989The N-methylthiotetrazole side chain (NMTT) that is present on several cephalosporins has been implicated in the development of antibiotic-associated... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
The N-methylthiotetrazole side chain (NMTT) that is present on several cephalosporins has been implicated in the development of antibiotic-associated hypoprothrombinemia. A randomized three-way crossover trial was conducted to compare the release of the NMTT side chain from three NMTT-containing antibiotics. Single 2-g doses of moxalactam, cefoperazone, and cefotetan were given, followed by serial blood and urine sampling. The concentrations of the parent compound and the NMTT side chain in plasma, urine, and the reconstituted antibiotic solution were determined by high-pressure liquid chromatography. Peak NMTT concentrations ranged from 0.42 to 16.50 micrograms/ml and were significantly higher after moxalactam administration than after cefoperazone or cefotetan administration (P less than 0.01). The NMTT trough concentrations (12.5 h) ranged from nondetectable to 2.47 micrograms/ml and tended to be greater following cefoperazone administration. The amounts of NMTT administered (e.g., the amount in the reconstituted antibiotic solution) were 25.8 +/- 1.4, 15.2 +/- 0.9, and 22.1 +/- 3.0 mg following moxalactam, cefoperazone, and cefotetan administration, respectively (P less than 0.01). In contrast, urinary recoveries of NMTT were 57.4 +/- 26.2, 73.6 +/- 44.3, and 29.7 +/- 22.9 mg following moxalactam, cefoperazone, and cefotetan, respectively. The amount of NMTT formed in vivo and excreted unchanged, as assessed by subtracting in vitro NMTT formation from NMTT urinary recovery, was significantly higher after cefoperazone than after moxalactam or cefotetan administration (P less than 0.05). The discrepancy between in vitro NMTT production (moxalactam > cefotetan > cefoperazone) and the amount of NMTT formed in vivo and excreted unchanged (cefoperazone > moxalactam > cefotetan) demonstrated that the in vivo production of NMTT is dependent on the disposition of the parent cephalosporin.
Topics: Adult; Azoles; Cefoperazone; Cefotetan; Chromatography, High Pressure Liquid; Female; Hematocrit; Humans; Infusions, Intravenous; Male; Moxalactam; Tetrazoles
PubMed: 2764537
DOI: 10.1128/AAC.33.6.857 -
Antimicrobial Agents and Chemotherapy May 1985The in vitro activity of BMY-28142, a new cephalosporin, was tested by a broth microdilution system and compared with those of cefotaxime, ceftazidime, cefoperazone,...
The in vitro activity of BMY-28142, a new cephalosporin, was tested by a broth microdilution system and compared with those of cefotaxime, ceftazidime, cefoperazone, moxalactam, and HR 810 against 747 bacterial isolates, one-third of which were resistant to one or more third-generation cephalosporins. BMY-28142 was the most active drug tested against 326 Enterobacteriaceae with an MIC for 90% of the organisms tested (MIC90) of 1.0 micrograms/ml. Against these Enterobacteriaceae the relative activities were: BMY-28142 greater than HR 810 greater than moxalactam and ceftazidime greater than cefotaxime greater than cefoperazone. For cefotaxime- and cefoperazone-resistant strains, the MIC90 of BMY-28142 was 4.0 micrograms/ml (compared with 0.13 micrograms/ml for susceptible strains). BMY-28142, with an MIC90 of 8.0 micrograms/ml for Pseudomonas aeruginosa, was about half as active as ceftazidime. The relative activities against P. aeruginosa were: ceftazidime greater than BMY-28142 greater than HR 810 greater than cefoperazone greater than moxalactam and cefotaxime. The MIC90 of BMY-28142 against staphylococci was 2.0 micrograms/ml, which was fourfold less active than HR 810, slightly less active than cefotaxime and cefoperazone, and fourfold more active than ceftazidime and moxalactam. BMY-28142 was very active against beta-lactamase-positive and -negative Haemophilus influenzae (MIC90, 0.06 micrograms/ml), Neisseria gonorrhoeae (MIC90, 0.015 micrograms/ml),aand nonenterococcal streptococci. Its activity against Streptococcus faecalis was poor (MIC90, 64 micrograms/ml). BMY-28142 was stable against the several beta-lactamases tested but exhibited little beta-lactamase inhibitory effect.
Topics: Bacteria; Cefepime; Cefoperazone; Cefotaxime; Ceftazidime; Cephalosporins; Drug Stability; Hydrolysis; Microbial Sensitivity Tests; beta-Lactamases; Cefpirome
PubMed: 3893316
DOI: 10.1128/AAC.27.5.679 -
Archives of Disease in Childhood Apr 1984Thirty one preterm neonates who had clinical, radiological, or bacteriological evidence of infection and who would normally have received gentamicin and penicillin were...
Thirty one preterm neonates who had clinical, radiological, or bacteriological evidence of infection and who would normally have received gentamicin and penicillin were treated with latamoxef (Moxalactam) 100 mg/kg/day. All were examined prospectively for clinical improvement and possible side effects. Biochemical and haematological values were monitored and pharmacokinetic variables determined. Thirty babies improved during treatment; latamoxef was effective in eradicating the infecting organisms in 7 of 9, including three babies infected with Lancefield group B streptococci. High serum concentrations of latamoxef were achieved after either intravenous or intramuscular administration and accumulation did not occur. Treatment had no effect on renal or hepatic function nor did it result in increased serum values of non-protein bound bilirubin. Clotting studies, where performed, were normal and no babies had bloody stools. Two disulfiram-like reactions were recorded. Latamoxef proved a safe and efficacious alternative to gentamicin with penicillin in the initial treatment of neonates with clinical evidence of infection.
Topics: Bacterial Infections; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Kinetics; Moxalactam; Prospective Studies
PubMed: 6721561
DOI: 10.1136/adc.59.4.346 -
Antimicrobial Agents and Chemotherapy Apr 1982The concentrations of metronidazole, clindamycin, chloramphenicol, cefoxitin, ticarcillin, and moxalactam in the serum, femurs, and scapulae of normal rats were measured... (Comparative Study)
Comparative Study
The concentrations of metronidazole, clindamycin, chloramphenicol, cefoxitin, ticarcillin, and moxalactam in the serum, femurs, and scapulae of normal rats were measured microbiologically 0.5, 1, 1, and 4 h after intravenous injection of 15-, 15-, 20-, 40-, 75-, and 30-mg/kg doses of the respective drugs. By 0.5 h metronidazole reached levels of 3.0 micrograms/g in compact femoral bone and 2.7 micrograms/g in cancellous scapular bone. Clindamycin and chloramphenicol reached levels of 8.1 and 6.1 micrograms/g, respectively, at 0.5 h. Cefoxitin penetrated bone to a level of 2.6 micrograms/g, whereas ticarcillin and moxalactam failed to reach significant levels in bone after single intravenous doses.
Topics: Animals; Anti-Infective Agents; Bone and Bones; Cefoxitin; Cephamycins; Chloramphenicol; Clindamycin; Metronidazole; Moxalactam; Rats; Rats, Inbred Strains; Ticarcillin; Time Factors
PubMed: 6211138
DOI: 10.1128/AAC.21.4.601 -
Antimicrobial Agents and Chemotherapy Mar 1982Moxalactam demonstrated marked activity against beta-lactamase-positive and -negative Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis by...
Moxalactam demonstrated marked activity against beta-lactamase-positive and -negative Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis by both standard minimal inhibitory concentration testing and growth curve studies. Moxalactam was ineffective against S. pneumoniae partially susceptible to penicillin G. Moxalactam (5 micrograms/ml) and penicillin (1 microgram/ml) in combination were indifferent to each other's antibacterial activity, exerting neither synergism nor antagonism against these organisms.
Topics: Bacteria; Cephalosporins; Cephamycins; Drug Interactions; Haemophilus influenzae; Meningitis; Microbial Sensitivity Tests; Moxalactam; Neisseria meningitidis; Penicillin G; Penicillin Resistance; Streptococcus pneumoniae
PubMed: 6213193
DOI: 10.1128/AAC.21.3.521 -
Applied and Environmental Microbiology Nov 1986By increasing the LiCl concentration to 5 g/liter and adding 20 mg of moxalactam per liter to modified McBride agar base, it was possible to inhibit the growth of many...
By increasing the LiCl concentration to 5 g/liter and adding 20 mg of moxalactam per liter to modified McBride agar base, it was possible to inhibit the growth of many bacteria which interfered with the recovery of Listeria monocytogenes from beef.
Topics: Animals; Cattle; Chlorides; Culture Media; Listeria monocytogenes; Lithium; Lithium Chloride; Meat; Moxalactam
PubMed: 3024563
DOI: 10.1128/aem.52.5.1215-1217.1986 -
Antimicrobial Agents and Chemotherapy May 1986Twelve parturient women volunteered to receive 1 g of cefotaxime on the second or third day postpartum by intravenous infusion over 3 min. Blood was taken from the...
Twelve parturient women volunteered to receive 1 g of cefotaxime on the second or third day postpartum by intravenous infusion over 3 min. Blood was taken from the antecubital vein of the contralateral arm at 0.25, 0.5, 0.75, 1, 2, 4, and 6 h. The concentration of cefotaxime in serum was assayed by agar diffusion, with Sarcina lutea ATCC 9341 as the indicator strain. The same 12 women received an identical dose of antibiotic 4 months after the first dose, and blood was taken at the same time intervals as in the first study to measure antibiotic levels. An additional 24 women participated in identical studies with either moxalactam or cefoperazone. Cefoperazone afforded the highest concentration in serum of the three drugs, followed by moxalactam. These differences in the concentration in serum were seen both early postpartum and 4 months later. However, the concentration in serum of all three drugs was diminished 2 and 3 days postpartum compared with 4 months postpartum. Most pharmacokinetic parameters were also significantly altered early in the puerperium relative to those obtained 4 months later. The altered pharmacokinetic behavior of antibiotics associated with pregnancy appears to persist into the early puerperium.
Topics: Adult; Cefoperazone; Cefotaxime; Female; Humans; Injections, Intravenous; Kinetics; Moxalactam; Postpartum Period; Pregnancy
PubMed: 3729345
DOI: 10.1128/AAC.29.5.873