Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Moxalactam kinetics during continuous ambulatory peritoneal dialysis (CAPD) was followed in eight patients after a single intraperitoneal dose of 1 g. Approximately 60% of the dose was absorbed after a dwell time of 4 h. Dialysis solutions were exchanged at 4-h intervals with an overnight dwell of 8 h. The mean (+/- standard deviation) elimination half-life was 13.2 +/- 2.9 h, and the mean apparent volume of distribution was 0.22 +/- 0.08 liters/kg. Mean total clearance was 11.5 +/- 2.4 ml/min, with a mean dialysis clearance of 2.3 +/- 0.5 ml/min. The maximum concentration in plasma ranged from 24.5 to 54.1 micrograms/ml. Moxalactam concentrations in the peritoneal dialysis fluid were above 80 micrograms/ml during the first exchange and above 2 micrograms/ml for a further three exchanges. A suggested intraperitoneal dose regimen for patients undergoing CAPD is 1 g initially, followed by 15 to 25% of the recommended dose for normal patients given at the same time intervals, or 30 to 50% of the recommended dose at twice the usual intervals. Moxalactam is suggested for initial treatment of peritonitis in CAPD patients who do not have ready access to the antibiotic of choice.
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PMID:Moxalactam kinetics during continuous ambulatory peritoneal dialysis after intraperitoneal administration. 383 35

The clinical efficacy of moxalactam versus clindamycin/tobramycin was evaluated in a comparative, randomized, prospective study. Sixty patients were treated: 30 with moxalactam and 30 with clindamycin/tobramycin. There were 15 cases of tuboovarian abscess, 36 cases of severe pelvic inflammatory disease with peritonitis, eight cases of endomyometritis, and one wound abscess. Aerobic and anaerobic cultures from the sites of infection yielded 441 microorganisms from 53 patients; an average of 8.3 bacteria per infection (4.5 anaerobes and 3.8 aerobes). The infections tended to be mixed aerobic-anaerobic with anaerobes isolated in 90% of cases. The most frequently isolated possible pathogens were Bacteroides sp. (37), Bacteroides bivius (23), Bacteroides asaccharolyticus (12), Peptococcus asaccharolyticus (29), Peptostreptococcus anaerobius (19), unidentified anaerobic gram-positive cocci (18), Escherichia coli (17), nonhemolytic streptococci (16), Neisseria gonorrhoeae (13), and Gardnerella vaginalis (38). Clinical cure was noted in 29 of 30 moxalactam-treated and 29 of 30 clindamycin/tobramycin-treated patients. Moxalactam was effective in five of six cases of tuboovarian abscess, all 22 cases of pelvic inflammatory disease with peritonitis, the one case of endomyometritis and the one wound abscess. Clindamycin/tobramycin was effective in eight of nine cases of tuboovarian abscess, all 14 cases of pelvic inflammatory disease with peritonitis, and all seven cases of endomyometritis. No adverse hematologic, renal, or hepatic effects were noted with either regimen.
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PMID:Moxalactam versus clindamycin plus tobramycin in the treatment of obstetric and gynecologic infections. 389 47

Continuous intraperitoneal administration of antibiotics has been recommended as treatment for peritonitis. The necessity of simultaneous systemic administration of antibiotics remains undefined but usually is performed. Moxalactam kinetics in serum were studied in dogs receiving 15 mg/kg intravenously; 15 mg/kg intraperitoneally; 5 mg/kg hourly with peritoneal lavage; 15 mg/kg intravenously followed by 5 mg/kg hourly intraperitoneally; 15 mg/kg intraperitoneally after 24 hours of peritonitis; and 5 mg/kg hourly by peritoneal lavage after 24 hours of peritonitis. Intraperitoneally administered moxalactam resulted in sustained serum levels compared with intravenously administered drugs. Repeated exchanges in lavage fluid resulted in progressively higher serum levels with each exchange. Peritonitis results in statistically higher levels of serum antibiotic concentration when compared with controls. Continuous intraperitoneal lavage with antibiotics would not appear to require concomitant systemic drug therapy.
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PMID:Serum kinetics of intraperitoneal moxalactam. 394 27

Sixty-seven patients were treated with moxalactam in a noncomparative trial of hospitalized patients; 32 had endometritis or chorioamnionitis, 12 had skin and soft tissue infections, 5 had osteomyelitis, 5 had pneumonia, 5 had urinary tract infections, 4 had arthritis, 2 had sepsis from an unknown source, 1 had endocarditis, and 1 had peritonitis. Bacteremia was present in 12 of these patients. Patients were given 3 to 12 g of moxalactam per day (mean, 6.24 g/day) in divided doses every 6 to 8 h. Seven patients were given intramuscular treatment for 3 to 20 days for part or all of their therapy. The rest were given intravenous treatment exclusively. Treatment was continued for 2 to 42 days (mean, 10 days). The dose and the duration of therapy were determined by the type of infection and the response of each patient. There were four treatment failures and one enterococcal-clostridial superinfection. Moxalactam was well tolerated. Allergic reactions led to the discontinuation of the antibiotic in three patients. Prolonged prothrombin and partial thromboplastin times were observed in 2 of 11 patients tested; in both instances in patients had severe underlying diseases, including malnutrition and alcoholism. Pain on intramuscular injection was noted in two patients receiving 1,500 mg, but not in five receiving a lower dose; in one case the pain forced the use of intravenous therapy after one dose, and in the other case the pain was mild and the patient was treated for 20 days. We concluded that moxalactam was effective in the treatment of the types of infections included in this study and produced few adverse reactions.
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PMID:Moxalactam in the therapy of serious infections. 621 Nov 40

Moxalactam was evaluated in vitro against 600 nosocomial isolates of gram-negative bacteria and was compared with cephalothin, cefoxitin, and cefotaxime. Moxalactam was superior to the other compounds, with minimal inhibitory concentrations of less than or equal to 4 micrograms/ml for 95% of the Enterobacteriaceae isolates and less than or equal to 8 micrograms/ml for 85% of the Bacteroides fragilis isolates; 70% of the Pseudomonas aeruginosa isolates were inhibited with less than or equal to 16 micrograms/ml. Moxalactam at doses ranging from 1 g every 12 hr to 2 g every 8 hr was given to patients with serious infections of the respiratory (14) or urinary (13) tract, abdominal abscess (4), osteomyelitis (4), meningitis (5), soft-tissue phlegmon (3), malignant external otitis (2), peritonitis (1), and panophthalmitis (1). The clinical response was excellent in 35 (74.5%) and improved in 12 (25.5%) of the 47 patients. The pathogen was eradicated in 29 (61.7%) patients, two patients had relapses, and bacteria persisted but in decreased numbers and without development of resistance in 16 patients. The half-life of moxalactam was 146 (+/- 21) and 125 (+/- 34) min after 2-g intravenous and 1-g intramuscular doses, respectively. Kinetic studies in sputum, bile, bone, aqueous humor, prostatic fluid, and cerebrospinal fluid showed moxalactam concentrations several times higher than the required MICs. No appreciable adverse effects or toxicity were observed.
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PMID:Moxalactam in serious infections: clinical, bacteriologic, and pharmacokinetic studies. 621 76

The authors have used Moxalactam as single antibiotic therapy in a series of 20 patients with primary or secondary peritonitis in order to test its efficiency on aerobic and anaerobic bacteria. Four early deaths and one late death not directly related to the peritoneal infectious process were recorded. In 95% of cases, the peritoneal infection was controlled by the association of Moxalactam and adequate surgery.
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PMID:[Moxalactam in complications of abdominal surgery]. 631 Jul 92

We evaluated the efficacy and toxicity of moxalactam during treatment of 45 documented infections in 36 patients. A majority of patients received 4.5 g of moxalactam per day. There was a good clinical response in 42 of the 45 (94%) infections, including 3 bacteremias, 20 skin and soft tissue infections, 6 gram-negative lower respiratory tract infections, 6 purulent diabetic foot ulcers, 3 wound infections, 3 urinary tract infections, and 4 miscellaneous infections (meningitis, suppurative phlebitis, peritonitis, bursitis). Previously, 11 of these patients had failed to respond to other antibiotics. Our three treatment failures were attributed to abnormal host defense in two patients and to a resistant enterococcal urinary tract infection in another. Moxalactam was tolerated well as produced minimal renal, hepatic, and hematological toxicities. The only serious adverse effect were the development of documented pseudomembranous colitis in one patient and progressive renal dysfunction in another. Acquisition of resistance among noneradicated isolates during therapy was not demonstrated.
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PMID:Moxalactam therapy for a wide spectrum of bacterial infections in adults. 645 55

We evaluated the rate and extent of the systemic absorption of moxalactam given intraperitoneally to patients with peritonitis and end-stage renal disease who were being maintained on continuous ambulatory peritoneal dialysis. Moxalactam was administered at a concentration of 200 mg per 2-liter dialysate for the first dose, followed by 60 mg per 2-liter exchange for 23 1-h exchanges. Moxalactam concentrations in serum (mean +/- standard deviation) were 2.5 +/- 0.9 mg/liter after the first hourly dialysis, increasing to 10.3 +/- 4.8 mg/liter after 24 h of drug administration. Moxalactam levels in serum at 1 h were above the minimal inhibitory concentrations for most gram-negative organisms except Pseudomonas aeruginosa. No adverse effects of the drug were observed.
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PMID:Peritoneal absorption of moxalactam. 662 55