A comparative study of cefoxitin, cefotaxime, moxalactam and aztreonam kinetics in saliva

In immunocompromised patients with serious gram-negative aerobic infections of the oral cavity, it is necessary to treat with antibiotics that possess a broad spectrum of activity and that display satisfactory kinetic properties. The purpose of the present study was to determine the serum and salivary pharmacokinetics of four new beta-lactam antibiotics: cefoxitin, cefotaxime, moxalactam and aztreonam. A total of 20 adult surgical in-patients (14 males and 6 females) were randomly assigned treatment by one of the four antibiotics. Each antibiotic was administered IV at a dose of 2 g IV every 8 hours. Serum and saliva levels were measured by the agar diffusion method .5, 2, 4, 6 and 8 hours after the third dose. The salivary concentrations of the four antibiotics were low, but, with the exception of cefoxitin, would be adequate to treat most infections of the oral cavity caused by enterobacteriaceae. No correlation was found between the antibiotic levels in the serum and the levels in the saliva.