We investigated the clinical efficiency and safety of
lamoxactam for treatment of 28 episodes of
infection in 26 adult patients (15 males and 11 females) whose ages ranged from 17 to 83 years (mean 48.7). 4 patients had 'ultimately fatal diseases' and the remaining 22 had 'nonfatal diseases'. The clinical condition at the beginning of treatment was 'critical' or 'poor' in 15 cases. Episodes of
infection treated were: 14 intraabdominal, 9
bacteremia, 5 nephro-urinary, 3
osteomyelitis, and a miscellaneous group including
pneumonia, soft tissue, parameningeal focus and infected V-P shunt. A total of 34 microorganisms were responsible for 25 episodes of
infection. 15 and 10 episodes were mono- and polymicrobial, respectively. Isolated microorganisms included 13 aerobic facultative gram-negative bacillus, 5 facultative gram-positive cocci, and 16 anaerobes. Total dosage of
lamoxactam administered by patient ranged from 24 to 234 g (mean 57.6 g), and mean
duration of therapy was 15.2 days (range 8-42 days). The overall rate of clinical response to
lamoxactam was excellent, amounting to 84% of episodes and 91% of patients. Local and general tolerance was good, and
lamoxactam had to be discontinued only once during
therapy due to an episode of
neutropenia. Enterococcal colonization (5 of 26 patients, 19%) and
superinfections (3 of 26 cases, 11.5%) were undesirably frequent in our patients.
Lamoxactam seems to be an effective and safe single-agent
therapy for many
bacterial infections. The possibility of enterococcal colonization and
superinfections should be monitored, specially in patients with urinary or
intraabdominal infections.