Cefepime Neurotoxicity: Case Report, Pharmacokinetic Considerations, and Literature Review
Corresponding Author
Dr. Sum Lam Pharm.D.
Department of Clinical Pharmacy Practice, College of Pharmacy and Allied Health Professions, St. John's University, Jamaica, New York
Divisions of Geriatric Medicine and Clinical Pharmacology, Department of Medicine, Winthrop University Hospital, Mineola, New York
Department of Clinical Pharmacy Practice, College of Pharmacy and Allied Health Professions, St. John's University, St. Albert's Hall, Room 114, 8000 Utopia Parkway, Jamaica, NY 11439; e-mail: [email protected]Search for more papers by this authorDr. Irving H. Gomolin M.D.C.M., FRCPC, FACP
Divisions of Geriatric Medicine and Clinical Pharmacology, Department of Medicine, Winthrop University Hospital, Mineola, New York
State University of New York at Stony Brook, Stony Brook, New York
Search for more papers by this authorCorresponding Author
Dr. Sum Lam Pharm.D.
Department of Clinical Pharmacy Practice, College of Pharmacy and Allied Health Professions, St. John's University, Jamaica, New York
Divisions of Geriatric Medicine and Clinical Pharmacology, Department of Medicine, Winthrop University Hospital, Mineola, New York
Department of Clinical Pharmacy Practice, College of Pharmacy and Allied Health Professions, St. John's University, St. Albert's Hall, Room 114, 8000 Utopia Parkway, Jamaica, NY 11439; e-mail: [email protected]Search for more papers by this authorDr. Irving H. Gomolin M.D.C.M., FRCPC, FACP
Divisions of Geriatric Medicine and Clinical Pharmacology, Department of Medicine, Winthrop University Hospital, Mineola, New York
State University of New York at Stony Brook, Stony Brook, New York
Search for more papers by this authorAbstract
A 67-year-old woman with diabetes mellitus, chronic renal insufficiency, and recurrent urinary tract infections experienced encephalopathy and myoclonus while receiving cefepime. The adverse drug event was accompanied by elevated cefepime levels and abnormal electroencephalograms. This syndrome resolved after discontinuation of cefepime. Neurotoxicity is a known but possibly underreported adverse event associated with cefepime in patients with renal impairment who receive relatively excessive doses. Most cases reverse on drug cessation. In patients with renal disease, the maintenance dosage should be reduced and the patient monitored for neurotoxicity. Cefepime toxicity should be suspected whenever a patient receiving the drug experiences a change in mental status or myoclonus.
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