moxalactam

Moxalactam is a semi-synthetic beta-lactam antibiotic belonging to the third-generation cephalosporin class. It was developed by Eli Lilly and Company and introduced in the early 1980s. Moxalactam is characterized by its oxacephem ring structure, which distinguishes it from traditional cephalosporins and contributes to its unique pharmacokinetic and pharmacodynamic properties. Its spectrum of activity includes a broad range of Gram-positive and Gram-negative bacteria, and it exhibits good stability against many beta-lactamase enzymes.

The mechanism of action of moxalactam, like other beta-lactam antibiotics, involves the inhibition of bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs) located in the bacterial cell membrane, thereby interfering with the final stages of peptidoglycan synthesis. This disruption leads to cell lysis and bacterial death. Moxalactam was particularly noted for its efficacy against anaerobic bacteria, a characteristic less common among other third-generation cephalosporins.

Moxalactam was primarily administered intravenously and was used to treat serious infections such as meningitis, pneumonia, and sepsis. However, its clinical use became limited due to concerns about adverse effects. A significant adverse effect associated with moxalactam was a prothrombin time abnormality, which could increase the risk of bleeding. This hemorrhagic diathesis was attributed to interference with vitamin K metabolism. Due to these safety concerns and the development of newer antibiotics with more favorable safety profiles, moxalactam is no longer widely used clinically in many parts of the world.