Pharmacokinetics of moxalactam in patients with normal and impaired renal function

Moxalactam is the first representative of a new class of potent beta-lactam antibiotics. To establish dosage recommendations, the kinetics of moxalactam elimination were studied in 20 patients with various degrees of renal dysfunction. After a 1-g intravenous bolus injection, the elimination half-life increased from 2.2 +/- 0.1 hr in normal subjects to 22.3 +/- 1.7 hr in anuric patients. Similar correlations were shown between the rate of creatinine clearance and the rate of plasma clearance, the rate of renal clearance, and the overall elimination rate constant of moxalactam. No changes in the distribution volumes or metabolic clearance rates of moxalactam were detected. A nomogram for adjustment of moxalactam dosage in patients with any level of renal function was generated, and specific recommendations for moxalactam dosage are discussed.