Relapse of Escherichia coli meningitis following therapy with moxalactam

Bacteriologic relapse occurred in a premature infant with Escherichia coli K1 meningitis 11 days following the completion of a 3-week course of therapy with the new 1-oxa-beta-lactam antibiotic moxalactam. Therapeutic failure was most probably the result of sequestration of viable bacteria in ventricular and/or paraventricular sites. While in vitro data and preliminary clinical evaluation of the new beta-lactam antibiotics indicate that these agents may be useful in the treatment of neonatal Gram-negative enteric meningitis, undue optimism regarding their efficacy, as with former agents, may be unwarranted.