Moxalactam therapy of bacterial meningitis in adults

The therapeutic efficacy and attainable cerebrospinal fluid (CSF) concentrations of moxalactam, administered by intravenous drip in a dose of 2 g every 4 to 8 h, were evaluated in seven adult patients with bacterial meningitis. Streptococcus pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter calcoaceticus var. antitratus, each caused infection in four patients, whereas Escherichia coli was the cause of infection in the other three patients. The mean moxalactam concentration in CSF was 14.7 μg/ml (range 4.7 to 38 μg/ml) in the lumbar samples and 12.1 μg/ml (range, 4.4 to 27 μg/ml) in the ventricular samples. Depending on the time after antibiotic administration, the ratio of CSF to serum concentrations varied from 6.6 to 160%. Satisfactory improvement and negative CSF cultures were initially noted in all seven patients. Six patients were ultimately cured, and the death of the patient with Pseudomonas meningitis could not be clearly attributed to uncontrolled infection.