Open AccessCefepime Induced Neurotoxicity: Case Series
Author(s) -
Sukanta Das,
Sukanta Das,
Akhila Kumar Panda,
Laxmidhar Parhi
Publication year - 2021
Publication title -
journal of clinical and diagnostic research
Language(s) - English
Resource type - Journals
eISSN - 2249-782X
pISSN - 0973-709X
DOI - 10.7860/jcdr/2021/49031.15045
Subject(s) - cefepime , medicine , neurotoxicity , electroencephalography , anesthesia , epilepsy , myoclonic jerk , pediatrics , intensive care medicine , toxicity , myoclonus , antibiotics , psychiatry , biology , antibiotic resistance , imipenem , microbiology and biotechnology
Cefepime is a broad-spectrum antimicrobial which is widely used for the treatment of both gram positive and gram negative pathogens, mainly in hospital setup for critically ill patients. Its half-life is around two hours and is primarily excreted via kidneys. However, in patients with renal impairment the half-life increases up to 13 hours. This may cause drug accumulation leading to several toxicities, of which neurotoxicity is of prime concern. Missing the diagnosis of these symptoms related to cefepime it may lead to increase in mortality or central nervous system dysfunction. Dose adjustment is recommended in such cases; however, several reports of neurological manifestations have been documented despite such modification. Here, is a series of six cases of cefepime induced neurotoxicity. The symptoms that the patients reported with were drowsiness, disorientation, non-convulsive epilepsy, slurred speech, tremors and myoclonic jerks. In all patients, cefepime was withdrawn and symptomatic management with anti-epileptic drug and monitoring with repeat Electroencephalogram (EEG) were done.