A Clinical Study of Moxalactam in the Treatment of Infections due to Gram-negative Bacilli

Abstract

47 episodes of infection due to gram-negative bacilli in 44 patients were treated with moxalactam in an open clinical trial of efficacy and safety. These included 25 urinary tract infections, 8 cases of pneumonia, 2 cases of meningitis, 3 wound and skin infections and 1 case each of peritonitis and osteomyelitis. 17 episodes of gram-negative bacteremia, either associated with local infection or primary septicemia, were treated. Cure, as defined as satisfactory clinical response with eradication of the infecting organism and absence of relapse, occurred in 34/47 episodes (72 %). Fatality was associated with 5/17 episodes of bacteremia, but rapid clearance of bacteremia occurred in all but one of the 12 survivors. The most significant complication of therapy was colonization and superinfection with moxalactam-resistant organisms. Fatal infection with moxalactam-resistant Serratia marcescens and Pseudomonas aeruginosa occurred in one case of pneumonia caused by S. marcescens initially sensitive to moxalactam. Significant adverse effects were primarily hematologic with prolongation of clotting times in 4 patients (associated with bleeding in 2), eosinophilia in 6 patients, and thrombocytosis in 4.