Successful treatment of gram-negative bacillary meningitis with moxalactam.

Abstract

Meningitis caused by enteric gram-negative bacilli is relatively uncommon but is very difficult to treat despite susceptibility in vitro to many antimicrobics. A major problem appears to be poor entry of many drugs into the central nervous system. Moxalactam is an investigational cephalosporin that attains concentrations in the cerebrospinal fluid that are 15% to 30% of contemporaneous serum concentrations; moreover, it is quite active against many of the enteric gram-negative bacilli. We used moxalactam to treat meningitis caused by Enterobacter cloacae, Klebsiella pneumoniae, and Escherichia coli in four adults and one child, giving up to 100 mg/kg body weight per day by intravenous injection. The concentrations of moxalactam in serum, lumbar, and ventricular cerebrospinal fluid exceeded the minimal lethal concentrations of all causative bacteria. The patients were cured. In this small series, moxalactam, when administered intravenously as the sole agent of therapy, was effective in the treatment of meningitis caused by susceptible gram-negative bacilli.

• Authors: D A Olson, P D Hoeprich, S M Nolan, E Goldstein
• Journal: Annals of internal medicine (Ann Intern Med) Vol. 95 Issue 3 Pg. 302-5 (Sep 1981) ISSN: 0003-4819 [Print] United States
• PMID: 6455950 (Publication Type: Case Reports, Journal Article)

Chemical References

• Cephalosporins
• Cephamycins
• Moxalactam

Topics

• Adult
• Cephalosporins (therapeutic use)
• Cephamycins (therapeutic use)
• Enterobacter
• Enterobacteriaceae Infections (drug therapy)
• Escherichia coli Infections (drug therapy)
• Female
• Humans
• Infant, Newborn
• Klebsiella Infections (drug therapy)
• Klebsiella pneumoniae
• Male
• Meningitis (drug therapy, physiopathology)
• Middle Aged
• Moxalactam