Absorption, excretion, and clinical efficacy of moxalactam in pediatric patients

Absorption and excretion of moxalactam were studied in 58 children between two and 14 years of age. Mean serum levels reached peaks of 96.6 and 76.0 micrograms/ml 15 min after intravenous injection of 20 and 10 mg of moxalactam/kg, respectively. The respective serum half lives were 103 and 83 min. Mean serum levels after intravenous drip infusion over a 1-hr interval reached peaks of 71.4 and 39.8 micrograms/ml at the end of the infusion of 20 and 10 mg/kg, respectively. The respective serum half lives were 103 and 94 min. Mean cumulative urinary recovery of the administered dose for the 6-hr interval after intravenous injection or drip infusion was approximately 73%. Among the patients from whom pathogens were isolated, satisfactory clinical response was obtained in 11 (92%) of 12 patients with meningitis, 4 (80%) of 5 patients with septicemia, all 9 patients with bronchitis, 32 (91.4%) of 35 patients with pneumonia, 33 (91.6%) of 36 patients with urinary tract infections, and all 8 patients with lymphadenitis or skin and soft-tissue infections. In all of the nine patients with meningitis for whom levels of the drug in cerebrospinal fluid were determined, levels of moxalactam were much higher than the minimal inhibitory concentrations for the pathogens, and these levels were associated with prompt clinical and bacteriologic responses. Adverse reactions were noted in only four of 279 treated patients.