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Article |

Coagulopathy Associated With the Use of Moxalactam

Robert L. Pakter, MD; Thomas R. Russell, MD; C. Harold Mielke, MD; David West, MD
JAMA. 1982;248(9):1100. doi:10.1001/jama.1982.03330090070035.
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MOXALACTAM disodium (Moxam) is a new β-lactam antibiotic with a broad clinical spectrum and is considered by some a third-generation cephalosporin. This report documents the development of significant coagulopathy in two patients shortly after the administration of the drug.

Report of Cases 

Case 1.—  A 68-year-old woman was admitted with left lower quadrant abdominal pain of two days' duration. After examination the patient underwent exploratory laparotomy and was found to have a gangrenous appendix with perforation. Bacteroides fragilis and group D streptococcus were cultured from the abdominal wound. Preoperative medications included methyldopa and hydrochlorothiazide. In the immediate postoperative period the patient was treated with moxalactam disodium, 2 g intravenously (IV) every eight hours; cimetidine, 300 mg IV every eight hours; and penicillin G potassium, 2 million units IV every four hours. The postoperative course was complicated by oliguria and serum creatinine elevation to 2.1 mg/dL on postoperative day 5, with


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