Latamoxef (moxalactam) in acute exacerbations of chronic bronchitis

Forty-three patients admitted to the hospital with acute exacerbations of chronic bronchitis were treated with latamoxef (moxalactam) twice daily intramuscularly for 10 days. Five patients received 0.5 g injections, 23 patients 1 g and 15 patients were given 2 g. Three patients dropped out of the study; one died suddenly, one was treated with another antibiotic because of suspected Gram-negative pneumonia and one developed pneumococcal septicaemia after the active treatment course. Most strains of Haemophilus influenzae, H. parainfluenzae and Branhamella catarrhalis were successfully eradicated but, by day 17, there were 7 patients with reinfections with Streptococcus pneumoniae. Latamoxef MIC values for Str. pneumoniae varied from 0.03 to 2 g mg/1, but most were in the region of 1 mg/1. Sputum concentrations reached approximately 1.5 mg/1 on the highest dosage but only 0.25 to 1 mg/1 on the lower doses. Peak Serum concentrations with the increasing doses averaged 14, 27 and 45 mg/1 respectively. The role and dosage of latamoxef in respiratory infections in the possible presence of streptococci are discussed.