Initial evaluation of kinetics and efficacy of moxalactam (LY-127935) in neonatal systemic gram-negative bacterial disease

Current antimicrobial therapy for systemic gram-negative bacterial infections during the newborn period is limited by the emergence of resistant strains and poor penetration of drugs into the central nervous system. Moxalactam, a new parenteral beta-lactam antibiotic, has an extended spectrum of coverage with good penetration of the blood-brain barrier. The pharmacokinetics and efficacy of moxalactam were studied in 5 neonates with serious gram-negative bacterial infections. Therapy was effective in all patients. In the dose employed (75 mg/kg/day), peak serum concentrations of 41.90 μg/ml were seen. Cerebrospinal fluid concentrations were 8-15% of simultaneous serum concentrations. In 4 patients without meningitis, and up to 69% of serum concentrations in one patient with inflamed meninges. Moxalactam deserves further evaluation in the therapy of systemic gram-negative bacterial infections in newborns.