Moxalactam therapy for a wide spectrum of bacterial infections in adults

We evaluated the efficacy and toxicity of moxalactam during treatment of 45 documented infections in 36 patients. A majority of patients received 4.5 g of moxalactam per day. There was a good clinical response in 42 of the 45 (94%) infections, including 3 bacteremias, 20 skin and soft tissue infections, 6 gram-negative lower respiratory tract infections, 6 purulent diabetic foot ulcers, 3 wound infections, 3 urinary tract infections, and 4 miscellaneous infections (meningitis, suppurative phlebitis, peritonitis, bursitis). Previously, 11 of these patients had failed to respond to other antibiotics. Our three treatment failures were attributed to abnormal host defense in two patients and to a resistant enterococcal urinary tract infection in another. Moxalactam was tolerated well as produced minimal renal, hepatic, and hematological toxicities. The only serious adverse effect were the development of documented pseudomembranous colitis in one patient and progressive renal dysfunction in another. Acquisition of resistance among noneradicated isolates during therapy was not demonstrated.