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Hemorrhagic tendency as a complication of Moxalactam therapy in bacterial meningitis
Abstract:
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.
Insights
Moxalactam shows promise for treating infant meningitis, but can prolong clotting times. Close monitoring and vitamin K are recommended during treatment.
Area of Science:
- Pharmacology
- Neonatal Medicine
- Infectious Diseases
Background:
- Moxalactam demonstrates good penetration into cerebrospinal fluid (CSF) and subdural fluid, indicating potential efficacy for treating enteric bacterial meningitis in neonates and infants.
- Previous clinical trials in adults and children have generally reported a low incidence of adverse effects.
Observation:
- This report details a bleeding complication, specifically prolonged prothrombin time (PT) and partial thromboplastin time (PTT), in two infants receiving Moxalactam.
- The complication occurred during a period of clinical improvement after Moxalactam was added to existing antibiotic therapy, to which the meningitis had not responded.
Findings:
- The observed hemostatic abnormalities (prolonged PT/PTT) in infants treated with Moxalactam warrant attention.
- The exact cause of this complication remains uncertain, potentially involving the underlying meningitis, combination antibiotic therapy, or multifactorial influences.
Implications:
- Further clinical observation and vigilant hemostatic monitoring are crucial for infants treated with Moxalactam.
- Timely administration of vitamin K should be considered during Moxalactam therapy to mitigate bleeding risks.