Carbenicillin-Induced Acidosis and Seizures

A patient with chronic, active pyelonephritis was treated with carbenicillin disodium, a drug that is generally accepted as having low toxicity to the central nervous system. While receiving a high dose of the drug the patient developed a combination of acute metabolic acidosis and grand mal seizures. The seizures, and in large part the acute acidosis, were the results of excessively high blood levels of carbenicillin which accumulated in the presence of nonoliguric renal impairment.