Imipenem-associated encephalopathy: alert to physicians

Finkelsztejn, Alessandro; Cabral, Lucélia; Silva, Aline Vitali da; Schumacher-Schuh, Artur

doi:10.1590/s0004-282x2010000100030

Cited by 7 publications

(3 citation statements)

References 5 publications

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“…First, this study is focused on imipenem, which has been used in more than 26 million patients26 and is a part of the carbapenem family, whose worldwide usage increased by 40 percent between 2000 and 2010. This is a large increase compared to all other antibiotics used, which increased by 30 percent during the same period 27.…”

Section: Discussionmentioning

confidence: 99%

Signal Detection of Imipenem Compared to Other Drugs from Korea Adverse Event Reporting System Database

et al. 2017

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PurposeTo detect signals of adverse drug events after imipenem treatment using the Korea Institute of Drug Safety & Risk Management-Korea adverse event reporting system database (KIDS-KD).Materials and MethodsWe performed data mining using KIDS-KD, which was constructed using spontaneously reported adverse event (AE) reports between December 1988 and June 2014. We detected signals calculated the proportional reporting ratio, reporting odds ratio, and information component of imipenem. We defined a signal as any AE that satisfied all three indices. The signals were compared with drug labels of nine countries.ResultsThere were 807582 spontaneous AEs reports in the KIDS-KD. Among those, the number of antibiotics related AEs was 192510; 3382 reports were associated with imipenem. The most common imipenem-associated AE was the drug eruption; 353 times. We calculated the signal by comparing with all other antibiotics and drugs; 58 and 53 signals satisfied the three methods. We compared the drug labelling information of nine countries, including the USA, the UK, Japan, Italy, Switzerland, Germany, France, Canada, and South Korea, and discovered that the following signals were currently not included in drug labels: hypokalemia, cardiac arrest, cardiac failure, Parkinson's syndrome, myocardial infarction, and prostate enlargement. Hypokalemia was an additional signal compared with all other antibiotics, and the other signals were not different compared with all other antibiotics and all other drugs.ConclusionWe detected new signals that were not listed on the drug labels of nine countries. However, further pharmacoepidemiologic research is needed to evaluate the causality of these signals.

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Section: Discussionmentioning

confidence: 99%

Signal Detection of Imipenem Compared to Other Drugs from Korea Adverse Event Reporting System Database

et al. 2017

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“…Recovery of encephalopathy despite withdrawal of imipenem eliminates the diagnosis of imipenem-associated encephalopathy [ 4 , 5 ]. To the best of our knowledge the literature contains no evidence of a higher incidence of neuropsychiatric adverse events (NPAEs) in patients treated with oseltamivir—an antiviral used to treat influenza— than in those that receive a placebo or no antiviral treatment; therefore, we think that encephalitis in the presented patient was likely to have been caused by H1N1, which is consistent with reports stating that the risk of NPAEs in influenza patients is significantly higher than in the general population, [ 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

H1N1 associated encephalitis in a child with acute myeloblastic leukemia and bacteremia due to Klebsiella pneumonia

Olcay¹,

Öztürkmen²,

Bıçakçı³

et al. 2012

Turk J Hematol

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Herein we present a neutropenic 16-year-old female with acute myeloblastic leukemia that developed recurrentgeneralized seizures while receiving antimicrobial therapy (including oseltamivir) due to pneumonia, bacteremiaof Klebsiella pneumoniae, and H1N1 infection. The patient’s seizures were controlled using assisted ventilation.Electroencephalography showed that the patient had encephalopathy. Cranial computed tomography (CT), magneticresonance imaging (MRI), and MRI angiography findings were normal. The patient fully recovered without sequelae.This case indicates that during pandemics of influenza-like diseases H1N1 infection should always be a consideration.

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“…Although myelosuppression and neurotoxicity are some of the more common adverse effects, especially in higher doses, specific toxicity thresholds have not been determined [ 15 , 54 ]. However, neurotoxicity is the most commonly reported adverse effect and occurs most frequently with the following β-lactams: benzylpenicillin, imipenem, cefepime, and ceftazidime [ 55 , 56 , 57 ].…”

Section: Antibiotics In the Icumentioning

confidence: 99%

Optimizing Antimicrobial Drug Dosing in Critically Ill Patients

et al. 2021

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A fundamental step in the successful management of sepsis and septic shock is early empiric antimicrobial therapy. However, for this to be effective, several decisions must be addressed simultaneously: (1) antimicrobial choices should be adequate, covering the most probable pathogens; (2) they should be administered in the appropriate dose, (3) by the correct route, and (4) using the correct mode of administration to achieve successful concentration at the infection site. In critically ill patients, antimicrobial dosing is a common challenge and a frequent source of errors, since these patients present deranged pharmacokinetics, namely increased volume of distribution and altered drug clearance, which either increased or decreased. Moreover, the clinical condition of these patients changes markedly over time, either improving or deteriorating. The consequent impact on drug pharmacokinetics further complicates the selection of correct drug schedules and dosing during the course of therapy. In recent years, the knowledge of pharmacokinetics and pharmacodynamics, drug dosing, therapeutic drug monitoring, and antimicrobial resistance in the critically ill patients has greatly improved, fostering strategies to optimize therapeutic efficacy and to reduce toxicity and adverse events. Nonetheless, delivering adequate and appropriate antimicrobial therapy is still a challenge, since pathogen resistance continues to rise, and new therapeutic agents remain scarce. We aim to review the available literature to assess the challenges, impact, and tools to optimize individualization of antimicrobial dosing to maximize exposure and effectiveness in critically ill patients.

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Imipenem-associated encephalopathy: alert to physicians

Cited by 7 publications

References 5 publications

Signal Detection of Imipenem Compared to Other Drugs from Korea Adverse Event Reporting System Database

Signal Detection of Imipenem Compared to Other Drugs from Korea Adverse Event Reporting System Database

H1N1 associated encephalitis in a child with acute myeloblastic leukemia and bacteremia due to Klebsiella pneumonia

Optimizing Antimicrobial Drug Dosing in Critically Ill Patients

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