[Moxalactam - a beta-lactam antibiotic in the monotherapy of severe infections in surgery. Clinico-bacteriological study of 35 patients].

Abstract

Moxalactam, a new beta-lactam antibiotic, was given to 35 patients at the Department of Surgery, Cantonal Hospital, St. Gall. The trial period started in April 1980 and ended in October. 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 7 0 anaerobic. The minimal inhibitory concentration was calculated for every isolate. In addition, the serum levels 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 one patient with a primarily moxalactam-resistant Bacteroides fragilis responsible for sepsis. In some patients a massive increase in Candida was noted 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 Streptococcus faecalis was necessary. Moxalactam was well tolerated and side effects were minimal. No impairment of renal function was noticed.

• Authors: H R Gonzenbach, W Sonnabend
• Journal: Schweizerische medizinische Wochenschrift (Schweiz Med Wochenschr) Vol. 111 Issue 31-32 Pg. 1169-83 (Aug 04 1981) ISSN: 0036-7672 [Print] Switzerland
• Vernacular Title: Moxalactam - ein beta-Lactam-Antibiotikum in Monotherapie bei schweren Infektionskrankheiten in der Chirurgie. Klinisch-bakteriologische Studie an 35 Patienten.
• PMID: 6456543 (Publication Type: Clinical Trial, English Abstract, Journal Article)

Chemical References

• Cephalosporins
• Cephamycins
• Moxalactam

Topics

• Abdomen (surgery)
• Adolescent
• Adult
• Aged
• Candidiasis (chemically induced)
• Cephalosporins (therapeutic use)
• Cephamycins (adverse effects, blood, therapeutic use)
• Clinical Trials as Topic
• Drug Resistance, Microbial
• Female
• Humans
• Male
• Microbial Sensitivity Tests
• Middle Aged
• Moxalactam
• Surgical Wound Infection (drug therapy, microbiology)