MOXALACTAM, A NEW BETA-LACTAM ANTIBIOTIC IN MONOTHERAPY FOR SEVERE INFECTIONS IN SURGERY - CLINICAL-BACTERIOLOGICAL STUDY OF 35 PATIENTS

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  • 1 January 1981
    • journal article
    • research article
    • Vol. 111  (31-3) , 1169-1183
Abstract
Moxalactam, a new .beta.-lactam antibiotic, was given to 35 patients. The trial period started in April 1980 and ended in Oct. Moxalactam was not combined with any other antibiotic. The clinical course was observed closely and extensive bacteriological, mycological and pharmacokinetic studies were carried out to evaluate the new antibiotic. Most of the patients had an intra-abdominal infectious disease and primary treatment was surgery. The antibiotic therapy was started at surgery. A total of 290 different bacteria could be isolated from the 35 patients; 220 isolates were aerobic and 70 anaerobic. The minimal inhibitory concentration was calculated for every isolate. The serum level of moxalactam was determined in almost every patient. In 31 patients (88.6%) the therapy was successful, in 2 patients no evaluation was possible and in 2 patients the therapy was unsuccessful, including 1 patient with a primarily moxalactam-resistant Bacteroides fragilis responsible for sepsis. In some patients a massive increase in Candida was noticed in the urine, stool or wound drainage. Primarily moxalactam-resistant organisms, such as Streptococcus faecalis, were often found alone in the samples taken later in the course of therapy. An extraordinary change in the fecal flora could be observed during therapy, but no clinical complications resulted. No specific antifungal therapy nor any additional antibiotic against S. faecalis was necessary. Moxalactam was well tolerated and side effects were minimal. No impairment of renal function was noticed.