latamoxef

Action and Spectrum

Actions and spectrum: 

Action: 

• Inhibition of Cell Wall Synthesis: latamoxef inhibits the synthesis of bacterial cell walls by interfering with the enzymes of cross-linking peptidoglycan strands, an essential component of the bacterial cell wall. 

Spectrum: latamoxef’s spectrum of activity includes both gram-positive and gram-negative bacteria, but it has a specific focus on anaerobic organisms and certain resistant strains. 

• Gram-Positive Bacteria: latamoxef is effective against certain gram-positive bacteria, including Streptococcus spp., Staphylococcus aureus, and other species that cause skin & soft tissue infections and urinary tract infections. 
• Gram-Negative Bacteria: latamoxef also covers a range of gram-negative bacteria, including some Enterobacteriaceae (such as Escherichia coli, Klebsiella spp.) and anaerobic bacteria like Bacteroides spp. 
• Anaerobic Bacteria: latamoxef’s notable feature is its efficacy against anaerobic bacteria. It is particularly useful in treating infections caused by anaerobic organisms that are resistant to other beta-lactam antibiotics. 
• Resistant Bacteria: latamoxef may be used in cases where other beta-lactam antibiotics are ineffective due to bacterial resistance mechanisms, such as extended-spectrum beta-lactamase (ESBL) production or beta-lactamase-mediated resistance. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Hypoprothrombinemia 

pain at injection site 

Fever 

cutaneous eruption 

Leucopenia 

diarrhoea 

eosinophilia 

thrombocytopenia 

Black Box Warning

Black Box Warning: 

There are no widely recognized black box warnings. 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Known Allergy or Hypersensitivity: latamoxef should not be used in individuals with a known hypersensitivity or allergy to cephalosporins, penicillins, or other beta-lactam antibiotics, as cross-reactivity may occur. 
• History of Severe Allergic Reactions: Individuals who have experienced severe allergic reactions (such as anaphylaxis) to beta-lactam antibiotics in the past should avoid latamoxef. 
• Serious Gastrointestinal Disease: latamoxef should be used with caution or avoided in individuals with a history of serious gastrointestinal disease, especially colitis, as it may worsen the condition or lead to antibiotic-associated colitis. 
• Central Nervous System (CNS) Disorders: latamoxef may cause central nervous system adverse effects like seizures, especially at higher doses. Individuals with a history of CNS disorders should be closely monitored if latamoxef is considered. 
• Coagulation Disorders: latamoxef can affect platelet function and the coagulation system. Caution is advised in individuals with bleeding disorders or those taking medications that affect blood clotting.

Caution: 

• Renal Impairment: latamoxef is excreted primarily through the kidneys. Individuals with renal impairment may require dose adjustments to prevent drug accumulation and potential adverse effects. Renal function should be monitored regularly. 
• Gastrointestinal Effects: latamoxef, like other antibiotics, can disturb the normal balance of gut bacteria and may lead to antibiotic-associated diarrhea or colitis. If severe diarrhea occurs during or after treatment, healthcare providers should be informed. 
• Seizures: latamoxef may lower the seizure threshold, particularly at high doses or in individuals with a history of seizures. Caution is advised in individuals with epilepsy or other conditions that increase the risk of seizures. 
• Coagulation Abnormalities: latamoxef may affect platelet function and coagulation. It should be used under caution in individuals with bleeding disorders, those taking anticoagulants, or those with a history of bleeding events. 
• Pregnancy and Breastfeeding: The safety of latamoxef in pregnancy and breastfeeding is not well established. The benefits & risks should be carefully considered before use during these periods.

Comorbidities: 

• Renal Impairment: latamoxef is primarily excreted through the kidneys. Individuals with renal impairment may require dose adjustments to prevent the accumulation of the medication in the body and potential adverse effects. 
• Liver Dysfunction: While latamoxef does not cause significant liver toxicity, individuals with pre-existing liver dysfunction may have impaired ability to metabolize drugs. Close monitoring of liver function may be necessary. 
• Neurological Disorders: Conditions such as meningitis or other central nervous system (CNS) infections may require careful consideration when using latamoxef due to its effects on the CNS. 
• Immunosuppression: Individuals with compromised immune systems, such as those with HIV/AIDS or undergoing immunosuppressive therapy, may be at increased risk of infections that require treatment with antibiotics like latamoxef. 
• Diabetes: Diabetic individuals may need close monitoring of their blood glucose levels while on latamoxef, as the medication can affect glucose metabolism. 
• Cardiovascular Diseases: While latamoxef is not directly associated with cardiovascular effects, individuals with pre-existing cardiovascular conditions should be monitored for any potential interactions or adverse effects. 

Pregnancy / Lactation

Pregnancy consideration: pregnancy category: not assigned 

Lactation: excreted into breast milk: unknown  

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
• <b>Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 
• Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology: 

latamoxef (moxalactam) is a beta-lactam antibiotic with a mechanism of action like other beta-lactam antibiotics, such as penicillins and cephalosporins. It is classified as a beta-lactamase inhibitor-resistant cephalosporin antibiotic. latamoxef exerts its antibacterial effects by inhibiting synthesis of bacterial cell walls.

It does so by binding to penicillin-binding proteins (PBPs) located on the bacterial cell membrane. These PBPs are responsible for the cross-linking of peptidoglycan strands in the cell wall, a crucial step in maintaining bacterial cell integrity and rigidity. Inhibition of PBPs leads to cell wall weakening, causing the bacterial cell to become susceptible to osmotic pressure and resulting in cell lysis.  

Pharmacodynamics: 

• Time-Dependent Bactericidal Activity: latamoxef’s bactericidal activity is time-dependent, meaning that its effectiveness is related to the duration of time its concentration remains above minimum inhibitory concentration (MIC). To achieve optimal therapeutic outcomes, maintaining sufficient drug levels in the body over a certain period is crucial. 
• Concentration-Dependent Killing: latamoxef also exhibits concentration-dependent killing, which means that higher concentrations of the drug result in a more rapid and effective killing of bacteria. This concentration-dependent effect is often associated with a post-antibiotic effect, where bacterial growth remains suppressed even after the concentration of drug falls below MIC. 
• Spectrum of Activity: latamoxef has a broad spectrum of activity, making it effective against a wide range of Gram-positive and Gram-negative bacteria. Its coverage includes various pathogens commonly associated with infections, such as Escherichia coli, Klebsiella pneumoniae, Proteus species, Streptococcus species, and some Staphylococcus species (including methicillin-sensitive strains). 
• Resistance: Bacterial resistance to latamoxef can develop through several mechanisms, including the production of beta-lactamase enzymes that can hydrolyze the beta-lactam ring of the antibiotic. However, latamoxef is designed to be less susceptible to certain beta-lactamases, contributing to its effectiveness against some resistant strains.

Pharmacokinetics: 

Absorption 

latamoxef is typically administered intravenously (IV), which allows for rapid and complete absorption of the drug directly into the bloodstream. Intravenous administration ensures that the drug reaches therapeutic concentrations quickly and effectively. 

Distribution 

After absorption, latamoxef is distributed throughout the body’s tissues and fluids, including interstitial fluids and extravascular spaces. The drug’s distribution is relatively broad, enabling it to access various sites of infection. latamoxef’s penetration into tissues and fluids contributes to its therapeutic effectiveness against both Gram-positive and Gram-negative bacteria. 

Metabolism 

latamoxef undergoes minimal metabolism in the body. The liver’s metabolic enzymes have limited involvement in the processing of latamoxef, and the drug is primarily eliminated through renal (kidney) excretion in its unchanged form. 

Elimination and excretion 

The primary route of elimination for latamoxef is renal excretion. The drug gets primarily excreted unchanged in the urine, with a significant portion of the administered dose being cleared from the body within a specific time frame. This renal elimination process helps maintain therapeutic drug levels and prevents potential drug accumulation. 

Adminstartion

Administration: 

Preparation: 

• latamoxef is supplied as a sterile powder in vials. Before administration, healthcare professionals must reconstitute the powder with a compatible diluent, usually sterile water for injection or a compatible IV solution. 
• The reconstitution process involves adding the specified volume of diluent to the vial and gently swirling or agitating until the powder is completely dissolved. Care should be taken to maintain sterility during this process. 

Dosage and Infusion: 

• The recommended dosage of latamoxef varies depending on the indication, severity of infection, and patient factors. Healthcare providers determine the appropriate dose based on clinical judgment and patient characteristics. 
• Once reconstituted, the solution is further diluted to the desired concentration with a compatible IV solution, like normal saline or sterile water for injection. 
• The diluted solution is then administered via intravenous infusion over a specific duration. The infusion rate is determined by the healthcare provider and is often guided by the manufacturer’s recommendations. 

Infusion Site and Monitoring: 

• latamoxef is typically infused through a peripheral vein or central venous catheter. The choice of infusion site depends on factors such as the patient’s venous access and the nature of the infection. 
• During the infusion, patients should be closely monitored for adverse reactions or complications, such as infusion-related reactions, changes in vital signs, or allergic responses. 

Frequency of Administration: 

• The frequency of latamoxef administration is determined by the healthcare provider and the specific indication being treated. 
• The duration of treatment with latamoxef varies based on the type and severity of the infection. Treatment courses can range from a few days to several weeks. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: latamoxef 

Pronounced: (lah-tuh-MOX-ef)  

Why do we use latamoxef? 

• Intra-abdominal Infections: latamoxef can be used to treat intra-abdominal infections such as peritonitis, abscesses, and infections of the abdominal cavity caused by susceptible bacteria. 
• Skin & Soft Tissue Infections: It is used in treating skin and soft tissue infections, including cellulitis, wound infections, and other bacterial infections involving the skin and underlying tissues. 
• Lower Respiratory Tract Infections: latamoxef can be used to treat lower respiratory tract infections like bronchitis, pneumonia, and lung abscesses caused by susceptible bacteria. 
• Urinary Tract Infections: It is indicated for the treatment of UTI caused by susceptible organisms, including both uncomplicated and complicated urinary tract infections. 
• Gynecological Infections: latamoxef can be used to treat gynecological infections such as pelvic inflammatory disease (PID) and infections of the reproductive organs caused by susceptible bacteria. 
• Bone and Joint Infections: It may be used to treat bone and joint infections like osteomyelitis and septic arthritis caused by susceptible bacteria.