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September 1982, Vol 136, No. 9 >
Article | September 1982

Moxalactam in the Treatment of Pediatric Infections FREE

Ram Yogev, MD; Michael Schreiber, MD; Sherry Gardner, RN; Stanford T. Shulman, MD
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Am J Dis Child. 1982;136(9):836-839. doi:10.1001/archpedi.1982.03970450078019.
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• The clinical efficacy and safety of the new oxacephalosporin moxalactam disodium were evaluated in 54 children with a variety of pediatric infections. Except for a terminally ill neutropenic leukemic patient with pneumonia and sepsis due to Pseudomonas aeruginosa who died shortly after initiation of therapy, moxalactam treatment was effective in all patients. No recurrent infections were observed. The rate of clinical response to moxalactam appeared to be at least comparable to that of patients treated with traditional antibiotics. In vitro sensitivity testing demonstrated that all bacteria isolated except P aeruginosa were sensitive to moxalactam while Haemophilus influenzae was exquisitely sensitive. Side effects included thrombocytosis (five patients), transient SGPT elevations and eosinophilia (three each), fever with rash (one), and neutropenia (one). In one patient, superinfection with Streptococcus faecalis developed. We conclude that moxalactam may be a useful antibiotic in pediatrics, particularly for the treatment of infections due to H influenzae and Enterobacteriaceae. Its role in infections caused by group B streptococcus and Pseudomonas awaits further studies.

(Am J Dis Child 1982;136:836-839)

REFERENCES

1 +
Simasathien S, Duangmani C, Echeverria P:  Haemophilus influenzae type b resistant to ampicillin and chloramphenicol in an orphanage in Thailand . Lancet 1980;;2:1214-1217.
2 +
Kenny JF, Isburg CD, Michaels RH:  Meningitis due to Haemophilus influenzae type b, resistant to both ampicillin and chloramphenicol . Pediatrics 1980;;66:14-16.
3 +
McCracken GH Jr, Mize SG, Threlkeld N:  Intraventricular gentamicin therapy in Gram-negative bacillary meningitis of infancy . Lancet 1980;;1:787-791.
4 +
Bradley JJ, Mayhall CG, Dalton HP:  Incidence and characteristics of antibiotic-tolerant strains of Staphylococcus aureus . Antimicrob Agents Chemother 1978;;13:1052-1057.
5 +
Heimdahl A, Von Konow L, Nord CE:  Occurrence of penicillin-resistant and β-lactamase producing Bacteroides species in the oral cavity , abstracted, in: Abstracts of the Annual Meeting of the American Society of Microbiology . Washington, DC, American Society for Microbiology, 1981;, A63.
6 +
Yoshida T, Matsuura S, Mayama M, et al:  Moxalactam (6059-S), a novel l-oxa-β-lactam with an expanded antibacterial spectrum: Laboratory evaluation . Antimicrob Agents Chemother 1980;;17:302-312.
7 +
Reimer LG, Mirrett S, Reller LB:  Comparison of in vitro activity of moxalactam (LY127935) with cefazolin, amikacin, tobramycin, carbenicillin, piperacillin, and ticarcillin against 420 blood culture isolates . Antimicrob Agents Chemother 1980;;17:412-416.
8 +
Lang SDR, Edwards DJ, Durack DT:  Comparison of cefoperazone, cefotaxime, and moxalactam (LY127935) against aerobic Gram-negative bacilli . Antimicrob Agents Chemother 1980;;17:488-493.
9 +
Hall WH, Opfer BJ, Gerding DN:  Comparative activities of the oxa-β-lactam LY127935, cefotaxime, cefoperazone, cefamandole, and ticarcillin against multiply resistant Gram-negative bacilli . Antimicrob Agents Chemother 1980;;17:273-279.
10 +
Borobio MV, Aznar J, Jimenez R, et al:  Comparative in vitro activity of l-oxa-β-lactam (LY127935) and cefoperazone with other β-lactam antibiotics against anaerobic bacteria . Antimicrob Agents Chemother 1980;;17:129-131.
11 +
Brown JE, DelBene VE, Collins CD:  In vitro activity of N-formimidoyl thienamycin, moxalactam, and other new β-lactam agents against Bacteroides fragilis: Contribution of β-lactamase to resistance . Antimicrob Agents Chemother 1981;;19:248-252.
12 +
Schaad UB, McCracken GH Jr, Threlkeld N, et al:  Clinical evaluation of a new broad-spectrum oxa-β-lactam antibiotic, moxalactam, in neonates and infants . J Pediatr 1981;;98:129-136.
13 +
Kaplan SL, Mason EO Jr, Garcia H, et al:  Pharmacokinetics and cerebrospinal fluid penetration of moxalactam in children with bacterial meningitis . J Pediatr 1981;;98:152-157.
14 +
Thornsberry C, Kirven LA:  Antimicrobial susceptibility of Haemophilus influenzae . Antimicrob Agents Chemother 1974;;6:620-624.
15 +
Shelton S, Nelson JD, McCracken GH Jr:  In vitro susceptibility of Gram-negative bacilli from pediatric patients to moxalactam, cefotaxime, Ro13-9904, and other cephalosporins . Antimicrob Agents Chemother 1980;;18:476-479.
16 +
Mason EO Jr, Kaplan SL, Anderson DC, et al:  In vitro susceptibility of 104 clinical isolates of Haemophilus influenzae to moxalactam (LY127935), ampicillin, chloramphenicol, and ticarcillin . Antimicrob Agents Chemother 1980;;17:470-473.
17 +
Cordera CS, Pekarek RS:  Treatment of experimental Haemophilus influenzae type b meningitis with l-oxa-β-lactam (LY127935) . Antimicrob Agents Chemother 1980;;17:258-262.
18 +
Varghese MC, Khan AJ, Patel V, et al:  Evaluation of LY127935 (LY) in pediatric patients , abstracted, in: Abstracts of the Annual Meeting of the American Society for Microbiology . 1981;, Washington, DC, American Society for Microbiology, A78.
19 +
Fisher JF, Carter MJ, Parsons J, et al:  Moxalactam (LY127935) in treatment of meningitis due to Gram-negative bacilli . Antimicrob Agents Chemother 1981;;19:218-221.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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References

1 +
Simasathien S, Duangmani C, Echeverria P:  Haemophilus influenzae type b resistant to ampicillin and chloramphenicol in an orphanage in Thailand . Lancet 1980;;2:1214-1217.
2 +
Kenny JF, Isburg CD, Michaels RH:  Meningitis due to Haemophilus influenzae type b, resistant to both ampicillin and chloramphenicol . Pediatrics 1980;;66:14-16.
3 +
McCracken GH Jr, Mize SG, Threlkeld N:  Intraventricular gentamicin therapy in Gram-negative bacillary meningitis of infancy . Lancet 1980;;1:787-791.
4 +
Bradley JJ, Mayhall CG, Dalton HP:  Incidence and characteristics of antibiotic-tolerant strains of Staphylococcus aureus . Antimicrob Agents Chemother 1978;;13:1052-1057.
5 +
Heimdahl A, Von Konow L, Nord CE:  Occurrence of penicillin-resistant and β-lactamase producing Bacteroides species in the oral cavity , abstracted, in: Abstracts of the Annual Meeting of the American Society of Microbiology . Washington, DC, American Society for Microbiology, 1981;, A63.
6 +
Yoshida T, Matsuura S, Mayama M, et al:  Moxalactam (6059-S), a novel l-oxa-β-lactam with an expanded antibacterial spectrum: Laboratory evaluation . Antimicrob Agents Chemother 1980;;17:302-312.
7 +
Reimer LG, Mirrett S, Reller LB:  Comparison of in vitro activity of moxalactam (LY127935) with cefazolin, amikacin, tobramycin, carbenicillin, piperacillin, and ticarcillin against 420 blood culture isolates . Antimicrob Agents Chemother 1980;;17:412-416.
8 +
Lang SDR, Edwards DJ, Durack DT:  Comparison of cefoperazone, cefotaxime, and moxalactam (LY127935) against aerobic Gram-negative bacilli . Antimicrob Agents Chemother 1980;;17:488-493.
9 +
Hall WH, Opfer BJ, Gerding DN:  Comparative activities of the oxa-β-lactam LY127935, cefotaxime, cefoperazone, cefamandole, and ticarcillin against multiply resistant Gram-negative bacilli . Antimicrob Agents Chemother 1980;;17:273-279.
10 +
Borobio MV, Aznar J, Jimenez R, et al:  Comparative in vitro activity of l-oxa-β-lactam (LY127935) and cefoperazone with other β-lactam antibiotics against anaerobic bacteria . Antimicrob Agents Chemother 1980;;17:129-131.
11 +
Brown JE, DelBene VE, Collins CD:  In vitro activity of N-formimidoyl thienamycin, moxalactam, and other new β-lactam agents against Bacteroides fragilis: Contribution of β-lactamase to resistance . Antimicrob Agents Chemother 1981;;19:248-252.
12 +
Schaad UB, McCracken GH Jr, Threlkeld N, et al:  Clinical evaluation of a new broad-spectrum oxa-β-lactam antibiotic, moxalactam, in neonates and infants . J Pediatr 1981;;98:129-136.
13 +
Kaplan SL, Mason EO Jr, Garcia H, et al:  Pharmacokinetics and cerebrospinal fluid penetration of moxalactam in children with bacterial meningitis . J Pediatr 1981;;98:152-157.
14 +
Thornsberry C, Kirven LA:  Antimicrobial susceptibility of Haemophilus influenzae . Antimicrob Agents Chemother 1974;;6:620-624.
15 +
Shelton S, Nelson JD, McCracken GH Jr:  In vitro susceptibility of Gram-negative bacilli from pediatric patients to moxalactam, cefotaxime, Ro13-9904, and other cephalosporins . Antimicrob Agents Chemother 1980;;18:476-479.
16 +
Mason EO Jr, Kaplan SL, Anderson DC, et al:  In vitro susceptibility of 104 clinical isolates of Haemophilus influenzae to moxalactam (LY127935), ampicillin, chloramphenicol, and ticarcillin . Antimicrob Agents Chemother 1980;;17:470-473.
17 +
Cordera CS, Pekarek RS:  Treatment of experimental Haemophilus influenzae type b meningitis with l-oxa-β-lactam (LY127935) . Antimicrob Agents Chemother 1980;;17:258-262.
18 +
Varghese MC, Khan AJ, Patel V, et al:  Evaluation of LY127935 (LY) in pediatric patients , abstracted, in: Abstracts of the Annual Meeting of the American Society for Microbiology . 1981;, Washington, DC, American Society for Microbiology, A78.
19 +
Fisher JF, Carter MJ, Parsons J, et al:  Moxalactam (LY127935) in treatment of meningitis due to Gram-negative bacilli . Antimicrob Agents Chemother 1981;;19:218-221.

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