Moxalactam (LY127935) in treatment of meningitis due to gram-negative bacilli

Moxalactam (LY127935; 6059S), a new broad-spectrum beta-lactam antibiotic, was used successfully with an aminoglycoside in a patient with Serratia marcescens meningitis complicating a neurosurgical procedure. With a bioassay method, peak and trough serum and cerebrospinal; fluid concentrations of moxalactam were determined during therapy. Mean peak and trough serum levels were 100.6 and 35.5 micrograms/ml, respectively. Corresponding mean peak and trough cerebrospinal fluid levels were 12.4 and 10.38 micrograms/ml. Cerebrospinal fluid levels of moxalactam exceeded the minimal bactericidal concentration for the infecting organism by more than 30-fold throughout therapy. No untoward effects of moxalactam were observed. Moxalactam may be a useful agent in the treatment of meningitis due to susceptible gram-negative bacilli.