Hemorrhagic tendency as a complication of Moxalactam therapy in bacterial meningitis.

Moxalactam penetrates cerebral spinal fluid (CSF) and subdural fluid well enough to be a promising antimicrobial for enteric bacterial meningitis in neonates and infants. Clinical trials in adults and children have found few adverse effects. Prolongation of prothrombin time (PT) and partial thromboplastin time (PTT) with or without bleeding was reported in adults. This paper reports this complication in two infants occurring at a time of clinical improvement following addition of Moxalactam to other antibiotics to which the meningitis had failed to respond. It is not certain if this complication was related to the underlying meningitis, the use of Moxalactam together with other antibiotics, or a combination of many factors. Further observation, close hemostatic monitoring, and timely vitamin K administration during its use are warranted.