Moxalactam therapy for gram-negative bacillary meningitis.

Twenty patients with gram-negative bacillary meningitis (19 episodes caused by enteric bacilli and one by Pseudomonas aeruginosa) were treated with moxalactam given intravenously. Seventeen patients responded well clinically and bacteriologically without known relapse. Fourteen of 18 isolates from cerebrospinal fluid were susceptible to less than or equal to 0.5 micrograms of moxalactam/ml. Cerebrospinal fluid concentrations of moxalactam in four patients were 2.4-16 micrograms/ml. This accumulated experience indicates that moxalactam has been effective in the treatment of patients with meningitis due to highly susceptible enteric gram-negative bacilli. However, it cannot be recommended as single-drug therapy for meningitis due to P. aeruginosa or Acinetobacter.