Cefepime-induced Encephalopathy with Triphasic Waves in Three Asian Patients

Abstract

Cefasporins such as cefepime are beta-lactam antibiotics with a broad antimicrobial spectrum. They are commonly used as first-line agents in the treatment of many infections.1 Reversible encephalopathy is a known neurotoxic complication of cefalosporins.2 Previous case reports have documented triphasic waves on electroencephalography (EEG) in cephalosporin-induced encephalopathy.1-4 Cefalosporin-induced encephalopathy with triphasic waves has not been previously reported among Asians. We report 3 Asian patients with toxic encephalopathy and documented triphasic waves on EEG while on treatment with cefepime.

Cefepime Neurotoxicity in Patients With Normal Renal Function: An Overlooked Cause of Encephalopathy in the Intensive Care Unit

“…lectroencephalography revealed diffuse slowing with triphasic waves, consistent with previous studies. 18 Despite a thorough workup, no alternative etiology was identified, and full neurological recovery occurred within 72 hours of discontinuing cefepime. These results highlight the importance of considering alternative antibiotics in cases of acute confusion associated with cefepime use when other causes have been ruled out.…”