Clinical evaluation of moxalactam: evidence of decreased efficacy in gram-positive aerobic infections.
AUTOR(ES)
Salzer, W
RESUMO
Moxalactam was used as initial, empirical therapy in 69 patients with a variety of serious bacterial infections, 32% of which were accompanied by bacteremia. Overall, the success rate was 83% and drug-related adverse effects were minimal. The drug was less efficacious in infections caused by aerobic gram-positive pathogens than it was in those caused by gram-negative pathogens. The following gram-positive organisms were associated with special problems during moxalactam therapy: Streptococcus pneumoniae (development of meningitis and a relapse of pneumonia with a more resistant strain), Staphylococcus epidermidis (in vivo emergence of moxalactam resistance, and the enterococci (failure of therapy and a fatal superinfection. Moxalactam performed well in infections caused by most gram-negative organisms, including aminoglycoside-resistant strains, but the previously reported emergence of gram-negative bacillary resistance to moxalactam during therapy was reconfirmed in our series with Serratia marcescens. The use of moxalactam in the treatment of gram-negative meningitis was further supported by a patient with meningitis-ventriculitis caused by Bacteroides fragilis who was cured with moxalactam after failure on chloramphenicol.
ACESSO AO ARTIGO
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=184702Documentos Relacionados
- Clinical evaluation of efficacy, pharmacokinetics, and safety of teicoplanin for serious gram-positive infections.
- Clinical evaluation of teicoplanin for therapy of severe infections caused by gram-positive bacteria.
- Ribosomal DNA Sequencing for Identification of Aerobic Gram-Positive Rods in the Clinical Laboratory (an 18-Month Evaluation)
- Evaluation of rapid identification of gram-positive cocci in positive blood cultures by use of the AutoMicrobic system Gram-Positive Identification Card.
- In Vitro Activity of Josamycin Against Aerobic Gram-Positive Cocci and Anaerobes