Abstract
The serum levels of moxalactam following a 1 g iv dose were studied in 16 patients with varying degrees of renal failure. In five patients the ratios of the R and S— epimers were measured. The data were consistent with moxalactam being excreted almost entirely by the kidneys. When the creatinine clearance fell below 30 ml/min the serum half-life was approximately double (about 5 h) that found in subjects with normal renal function and when the creatinine clearance was 10 ml/min the serum half-life was 12 to 15 h. The ratio R : S decreased over 1 to 6 h in those patients with good renal function (creatinine clearance > 30 ml/min). It is suggested that dosage should be reduced by one half from 1 g twice daily to 1 g per day for patients with a creatinine clearance of 30 ml/min and if the creatinine clearance is below 10 ml/min a dose of 1 g on alternate days be used.
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