Cefuroxime‐induced encephalopathy

Abstract

We describe four patients who developed an encephalopathic syndrome characterized by obtundation or stupor, myoclonic jerks, and asterixis in association with cefuroxime therapy. Three patients had renal failure. These cases suggest that cefuroxime in overdose or in conventional doses in patients with renal failure can cause a reversible encephalopathy. This syndrome may have been unrecognized because it usually occurs in severely ill patients with additional causes for encephalopathy.

Cephalosporin-Induced Neurotoxicity: Clinical Manifestations, Potential Pathogenic Mechanisms, and the Role of Electroencephalographic Monitoring

“…While the patient's mental status may improve within hours of drug cessation, the EEG may not be void of sharp waves or bursts for several days. 12 Some authors have alluded to the possibility that EEG abnormalities reflect underlying metabolic changes rather than frank epileptic activity in the same way that one may see triphasic waves in patients with hepatic or uremic encephalopathy. 35 However, the cases discussed here of cefepime-induced toxicity with similar EEG findings occurring in the absence of other metabolic derangements would suggest otherwise.…”

Community-acquired bacterial meningitis in adults

“…The high mortality warrants a low threshold for starting antiepileptic therapy in those with clinical suspicion of seizures. A rare cause of seizures, asterixis and encephalopathy is the neurotoxic effect of certain antimicrobial agents (cefuroxime, penicillin, imipenem)41, 42 which should be suspected in a patient with prior stroke or Parkinson’s disease and in those with renal insufficiency, and when there are no other obvious causes of seizures.…”

Gentamicin-induced Myoclonus

“…[3][4][5][6][7][8][9][10][11][12][13][14][15][16] Age and renal dysfunction have been shown to be the 2 very important factors in the development of medication toxicity. Two main contributing factors to the pathophysiology of AIM may be an excess accumulation of drugs in the cerebrospinal fluid (CSF) and the neurotoxic effects on the brain caused by the antibiotics themselves.…”