Cefepime-induced Neurotoxicity: Five Cases Reported in a Single Institution

• Published in: Curēus (Palo Alto, CA) Vol. 10; no. 11; p. e3666
• Main Authors: Schlidt, Kevin, Kadlec, Andrew, Bhandari, Sanjay, Jha, Pinky
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 30-11-2018; Cureus
• Subjects: Antibiotics; Blood; Case reports; Diabetes; Drug dosages; Electroencephalography; Family medical history; Hemodialysis; Hospitals; Hypertension; Infections; Infectious Disease; Infectious diseases; Internal Medicine; Kidney diseases; Medical Education; Metabolism; Neurotoxicity; NMR; Nuclear magnetic resonance; Patients; Pneumonia; Rehabilitation; Urogenital system; United States > US; renal failure; cefepime; neurotoxicity; encephalopathy
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.3666

Cefepime is a fourth-generation cephalosporin widely used to treat gram-positive and gram-negative infections. Its half-life is approximately two hours in patients with normal renal function and may increase to 13.5 hours in patients with acutely or chronically impaired renal function. Although dosage adjustment is recommended for patients with renal insufficiency to prevent drug accumulation, toxicity has been reported in patients even with normal renal function. One underreported complication of cefepime toxicity is cefepime-induced encephalopathy (CIE). While the pathophysiology is unclear, treatment involves early discontinuation of this antibiotic to decrease morbidity and mortality. We report five cases of cefepime-induced encephalopathy occurring within one year at a single institution.