title: New drug evaluations: moxalactam (Moxam, Eli Lilly).
abstract: Moxalactam is a new 1-oxa-beta-lactam antibiotic that is similar in many respects to the third-generation cephalosporins. Moxalactam is exceptionally stable to beta-lactamase enzymes and inhibits most gram-negative aerobic bacteria, with the frequent exception of P. aeruginosa. Moxalactam is active against most B. fragilis organisms and appears to be an effective alternative to an aminoglycoside/clindamycin combination for patients with intraabdominal infections. Moxalactam penetrates through inflamed meninges and may become the drug of choice for gram-negative bacillary meningitis due to susceptible organisms. Moxalactam would be expected to be no more effective than the third-generation cephalosporins for other gram-negative infections, and it has not been clearly shown that these agents are as effective as aminoglycoside antibiotics for most serious gram-negative infections. Because of moxalactam's high cost, its potential for misuse, and its unknown long-term effects on microbial resistance patterns, as well as the lack of comparative efficacy studies for many infections, the hospital use of moxalactam should be closely monitored.
mesh_terms: D000900:Anti-Bacterial Agents / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects; D001424:Bacterial Infections / Q000188:drug therapy*; D002511:Cephalosporins / Q000627:therapeutic use*; D002513:Cephamycins / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D006801:Humans; D007700:Kinetics; D009070:Moxalactam
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D002513:Cephamycins; D009070:Moxalactam