Severe Neurotoxicity of Cefepime in Uremic Patients

Letters4 December 2001Severe Neurotoxicity of Cefepime in Uremic PatientsFrédéric Barbey, MD, Denis Bugnon, MD, and Jean-Pierre Wauters, MDFrédéric Barbey, MDUniversity Hospital; 1011 Lausanne, SwitzerlandSearch for more papers by this author, Denis Bugnon, MDUniversity Hospital; 1011 Lausanne, SwitzerlandSearch for more papers by this author, and Jean-Pierre Wauters, MDUniversity Hospital; 1011 Lausanne, SwitzerlandSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-11-200112040-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Reports of seizures with cefepime therapy are extremely rare (1). We present three cases of cefepime-induced severe neurotoxicity in two patients receiving long-term hemodialysis and one patient with a creatinine clearance of 0.42 mL/s (25 mL/min). All three patients were receiving cefepime, 2 g/d, with a supplementary dose of 1 g postdialysis, as recommended (2).Patient 1 (body weight, 86 kg) had progressive confusion with global aphasia after 3 days of therapy. Patient 2 (body weight, 42 kg) became aphasic with subtle tremorlike activity of the eyelids on the 5th day of treatment. Patient 3 (body weight, ...References1. Neu HC. Safety of cefepime: a new extended-spectrum parenteral cephalosporin. Am J Med. 1996;100:68S-75S. [PMID: 8678100] CrossrefMedlineGoogle Scholar2. . Gilbert DN, Moellering RC, Sande ME, eds. Guide to Antimicrobial Therapy. New York: Sanford Guide; 2000. Google Scholar3. Barbhaiya RH, Knupp CA, Forgue ST, Matzke GR, Guay DR, Pittman KA. Pharmacokinetics of cefepime in subjects with renal insufficiency. Clin Pharmacol Ther. 1990;48:268-76. [PMID: 2401125] CrossrefMedlineGoogle Scholar4. Schmaldienst S, Traunmüller F, Burgmann H, Rosenkranz AR, Thalhammer-Scherrer R, Hörl WH, et al . Multiple-dose pharmacokinetics of cefepime in long-term hemodialysis with high-flux membranes. Eur J Clin Pharmacol. 2000;56:61-4. [PMID: 10853879] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Frédéric Barbey, MD; Denis Bugnon, MD; Jean-Pierre Wauters, MDAffiliations: University Hospital; 1011 Lausanne, Switzerland PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCefepime-induced neurotoxicity: systematic reviewClinical Pharmacokinetics and Pharmacodynamics of CefepimeUsing precision dosing to minimize cefepime-induced neurotoxicity: The challenge of targetsEncephalopathyCefepime dosing regimens in critically ill patients receiving continuous renal replacement therapy: a Monte Carlo simulation studyA Monte Carlo Simulation Approach for Beta-Lactam Dosing in Critically Ill Patients Receiving Prolonged Intermittent Renal Replacement TherapyNeurological Adverse Effects Attributable to β-Lactam Antibiotics: A Literature ReviewCefepime-induced neurotoxicity: a systematic reviewCharacterizing Cefepime Neurotoxicity: A Systematic ReviewA case of Cefepime encephalopathy, being difficult to distinguish from non-convulsive status epilepticus during the treatment of bacterial meningitisIntermittent hemodialysis treatment in cefepime-induced neurotoxicity: Case report, pharmacokinetic modeling, and review of the literatureAntibiotic therapy for inducible AmpC β-lactamase-producing Gram-negative bacilli: what are the alternatives to carbapenems, quinolones and aminoglycosides?EncephalopathyNeurotoxic effects associated with antibiotic use: management considerationsHigh Cefepime Plasma Concentrations and Neurological Toxicity in Febrile Neutropenic Patients with Mild Impairment of Renal FunctionCefepime-Associated Status Epilepticus in an ICU Patient with Renal FailureCefepime-Induced Neurotoxicity: A Review of the EvidenceAn In Vivo–In Vitro Study of Cefepime and Cefazolin Dialytic Clearance During High-Flux HemodialysisCefepime Neurotoxicity: Case Report, Pharmacokinetic Considerations, and Literature ReviewEncefalopatia induzida por cefepime: achados clínicos e eletroencefalográficos em sete pacientesNeurotoxicity Secondary to Intraperitoneally Administered Cefepime: Report of Two CasesReversible Coma Secondary to Cefepime NeurotoxicityRetrospective Review of Neurotoxicity Induced by Cefepime and CeftazidimeCurrent AwarenessCefepime 4 December 2001Volume 135, Issue 11Page: 1011KeywordsBody weightBrain diseasesDrugsElectroencephalographyEpilepsyEpileptic seizuresLesionsPatientsRenal failureSepsis ePublished: 4 December 2001 Issue Published: 4 December 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...