1080 evaluation of moxalactam for the treatment of meningitis due to s. Pneumoniae with differing susceptibilities to penicillin

1080 evaluation of moxalactam for the treatment of meningitis due to s. Pneumoniae with differing susceptibilities to penicillin

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ABSTRACT Thirty-four strains of S. pneumoniae(Sp), 2 penicillin(pen) resistant(r), 12 pen relatively resistant(rr) and 20 pen susceptible(s) were tested against moxalactam(mox) by disk diffusion, agar and micro-broth dilution and killing curve methods. The 2 pen-r strains required >32ug/ml mox for inhibition. MICs of mox for the 12 pen-rr strains ranged from 1-16ug/ml with modal MICs of 8ug/ml. Fifty percent of the pen-s strains were inhibited by 1 ug/ml and 95% by 2ug/ml of mox. Cross-resistance to mox was noted for pen-r and most of the pen-rr strains. Mox was compared to pen therapy in rabbits with bacterial meningitis induced by intracisternal inoculation of 107-108 CFU/ml. Two different strains were used: strain one mox MIC=lug/ml, pen MIC=0.03ug/ml. strain two mox MIC=8ug/ml, pen MIC=0.5ug/ml. Antibiotics were given every 4hr for 16hr in 50mg/kg/dose(mox) and 100,000U/kg/dose(pen). The mean % penetration into the CSF (CSF/serum × 100) were mox:17%, pen:3%, resulting in peak concentration ≥ fourfold MIC of the pen sensitive strain. There was no significant reduction of CSF bacterial titers with mox vs untreated controls for both strains, whereas pen reduced titers of sensitive strains (p <.001). Mox is less active than pen against Sp in vitro and in experimental meningitis. It should not be used alone in the initial treatment of infants with meningitis. ARTICLE PDF AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma Martha M Tarpay, David F Welch & Melvin I Marks Authors * Martha M Tarpay View author publications You can also search for this author inPubMed Google Scholar * David F Welch View author publications You can also search for this author inPubMed Google Scholar * Melvin I Marks View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Tarpay, M., Welch, D. & Marks, M. 1080 EVALUATION OF MOXALACTAM FOR THE TREATMENT OF MENINGITIS DUE TO S. PNEUMONIAE WITH DIFFERING SUSCEPTIBILITIES TO PENICILLIN. _Pediatr Res_ 15 (Suppl 4), 622 (1981). https://doi.org/10.1203/00006450-198104001-01106 Download citation * Issue Date: 01 April 1981 * DOI: https://doi.org/10.1203/00006450-198104001-01106 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative

ABSTRACT Thirty-four strains of S. pneumoniae(Sp), 2 penicillin(pen) resistant(r), 12 pen relatively resistant(rr) and 20 pen susceptible(s) were tested against moxalactam(mox) by disk


diffusion, agar and micro-broth dilution and killing curve methods. The 2 pen-r strains required >32ug/ml mox for inhibition. MICs of mox for the 12 pen-rr strains ranged from 1-16ug/ml


with modal MICs of 8ug/ml. Fifty percent of the pen-s strains were inhibited by 1 ug/ml and 95% by 2ug/ml of mox. Cross-resistance to mox was noted for pen-r and most of the pen-rr strains.


Mox was compared to pen therapy in rabbits with bacterial meningitis induced by intracisternal inoculation of 107-108 CFU/ml. Two different strains were used: strain one mox MIC=lug/ml, pen


MIC=0.03ug/ml. strain two mox MIC=8ug/ml, pen MIC=0.5ug/ml. Antibiotics were given every 4hr for 16hr in 50mg/kg/dose(mox) and 100,000U/kg/dose(pen). The mean % penetration into the CSF


(CSF/serum × 100) were mox:17%, pen:3%, resulting in peak concentration ≥ fourfold MIC of the pen sensitive strain. There was no significant reduction of CSF bacterial titers with mox vs


untreated controls for both strains, whereas pen reduced titers of sensitive strains (p <.001). Mox is less active than pen against Sp in vitro and in experimental meningitis. It should


not be used alone in the initial treatment of infants with meningitis. ARTICLE PDF AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Pediatrics, University of Oklahoma Health


Sciences Center, Oklahoma City, Oklahoma Martha M Tarpay, David F Welch & Melvin I Marks Authors * Martha M Tarpay View author publications You can also search for this author inPubMed 


Google Scholar * David F Welch View author publications You can also search for this author inPubMed Google Scholar * Melvin I Marks View author publications You can also search for this


author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Tarpay, M., Welch, D. & Marks, M. 1080 EVALUATION OF MOXALACTAM FOR


THE TREATMENT OF MENINGITIS DUE TO S. PNEUMONIAE WITH DIFFERING SUSCEPTIBILITIES TO PENICILLIN. _Pediatr Res_ 15 (Suppl 4), 622 (1981). https://doi.org/10.1203/00006450-198104001-01106


Download citation * Issue Date: 01 April 1981 * DOI: https://doi.org/10.1203/00006450-198104001-01106 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this


content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative