Disease relevance of moxalactam

• Moxalactam therapy for neonatal meningitis due to gram-negative enteric bacilli. A prospective controlled evaluation [1].
• Moxalactam, bleeding, and renal insufficiency [2].
• Enzyme-mediated resistance of Bacteroides fragilis to moxalactam [3].
• Enterococcal superinfection and colonization after therapy with moxalactam, a new broad-spectrum antibiotic [4].
• Hypoprothrombinemia has occurred frequently with cephalosporins that possess a methylthiotetrazole substitution (cefamandole, moxalactam, and cefoperazone) [5].

Psychiatry related information on moxalactam

• Three Pseudomonas aeruginosa strains which constitutively produced chromosomal (Id, or Sabath and Abraham) beta-lactamase in large amounts were resistant to latamoxef (moxalactam) MICs, 128-256 mg/l) [6].

High impact information on moxalactam

• Case-fatality rates were 23% and 15% for moxalactam-treated infants and ampicillin- and amikacin-treated infants, respectively [1].
• Prolonged bleeding time associated with 'low-dose' moxalactam therapy [7].
• Prolonged bleeding times and bleeding diathesis associated with moxalactam administration [8].
• Moxalactam and hemorrhage [9].
• The concentrations of moxalactam in serum, lumbar, and ventricular cerebrospinal fluid exceeded the minimal lethal concentrations of all causative bacteria [10].

Chemical compound and disease context of moxalactam

• Clinical trials with moxalactam suggest that it is the most effective regimen for enteric gram-negative bacillary meningitis in adults; Pseudomonas aeruginosa and acinetobacter meningitis are most susceptible to a combination of intravenous ticarcillin and aminoglycoside, plus intrathecal aminoglycoside [11].
• In addition, two cases of Escherichia coli meningitis in which moxalactam therapy inexplicably failed were cured with cefotaxime [12].
• These results suggest that the overall efficacy and toxicity of moxalactam plus piperacillin and moxalactam plus amikacin are similar [13].
• On the other hand, bacteremic enterococcal superinfections occurred in seven patients receiving moxalactam plus amikacin but in none given moxalactam plus piperacillin (p = 0.02) [13].
• Overall, 45 aerobic and 25 anaerobic bacteria were isolated from the ticarcillin plus clavulanic acid-treated patients; 58 aerobic and 24 anaerobic bacteria were isolated from the moxalactam-treated patients [14].

Biological context of moxalactam

• We report here the crystal structure of the Stenotrophomonas maltophilia L1 enzyme in complex with the hydrolysis product of the 7alpha-methoxyoxacephem, moxalactam [15].
• Moxalactam epimer kinetics in children [16].
• Pharmacokinetics of moxalactam in elderly subjects [17].
• A total of 13% of the patients in the moxalactam group developed a prolonged prothrombin time (P less than 0.01), and three patients demonstrated clinical bleeding [18].
• Protein binding of moxalactam in both normal and uremic serum was determined by ultracentrifugation [19].

Anatomical context of moxalactam

• Except for some severe P aeruginosa infections outside the urinary tract, moxalactam is effective and safe single-agent therapy for infections caused by susceptible organisms and represents a major advancement in beta-lactam antimicrobial therapy [20].
• The higher incidence of the more active R epimer and the 500% interpatient variation in clearance may indicate a need for monitoring serum and cerebrospinal fluid concentrations in patients with severe unresponsive central nervous system infectious treated with moxalactam [16].
• An Escherichia coli strain, HKYM68, which showed resistance to broad-spectrum cephalosporins was isolated from a sputum specimen in Japan. The high-level resistance of the strain to ceftazidime, cefpirome, and moxalactam was carried by a self-transferable plasmid [21].
• Moxalactam showed essentially complete penetration into valve lesions, whereas concentrations in heart muscle were only 20% of those in serum [22].
• Although moxalactam is eliminated primarily by the kidney a chromatogram of the feces from volunteers who received multiple doses showed that it is also excreted as the parent compound in to the feces via the biliary tract [23].

Associations of moxalactam with other chemical compounds

• The efficacy and safety of double beta-lactam therapy with cefoperazone plus piperacillin in febrile granulocytopenic patients were compared with moxalactam plus piperacillin, ceftazidime plus piperacillin, and imipenem alone in two separate clinical trials [24].
• There were six treatment failures in the moxalactam group and 10 failures in the tobramycin group (p greater than 0.4) [25].
• Comparative study of ticarcillin plus clavulanate potassium and moxalactam in the treatment of surgical infections of the soft tissue [26].
• We conclude that moxalactam pretreatment may induce a disulfiram-like reaction after ethanol ingestion in some, probably due to inhibition of aldehyde dehydrogenase, and that alcoholic beverages are contraindicated in patients receiving moxalactam [27].
• The elimination half-life of cefotaxime was 1.2 h, and that of moxalactam was 2.85 h [28].

Gene context of moxalactam

• The newer cephalosporins or cehalosporin-type antibiotics (cefotaxime, moxalactam), by virtue of their marked activity against gram-negative bacilli and their ability to achieve significant CSF levels, merit serious consideration as therapy for gram-negative bacillary meningitis [29].
• The affinity of moxalactam for its target penicillin-binding proteins was unchanged, as was the level of beta-lactamase activity [30].
• These findings suggest that MOX-1 is a plasmid-mediated AmpC-type beta-lactamase that provides enteric bacteria resistance to broad-spectrum beta-lactams, including moxalactam [31].
• Inactivation of cefoxitin and moxalactam by Bacteroides bivius beta-lactamase [32].
• Moxalactam demonstrated marked activity against beta-lactamase-positive and -negative Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis by both standard minimal inhibitory concentration testing and growth curve studies [33].

Analytical, diagnostic and therapeutic context of moxalactam

• 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 [10].
• Thirty-three patients received 3.1 g of ticarcillin plus clavulanic acid every six hours via intravenous infusion, and 36 patients received 2.0 g of moxalactam every eight hours via intravenous infusion [14].
• Six of 14 treatment failures involved P. aeruginosa, and P aeruginosa isolates resistant to moxalactam emerged during therapy of 12 infections [20].
• Moxalactam kinetics in hemodialysis [34].
• Moxalactam epimer disposition in patients undergoing continuous ambulatory peritoneal dialysis [35].

References