Coma sous Ertapénème

Ohlmann, Camille; Cambon, A.; Gall, Astrid; Mollimard, B.; Nzondo, M. Kedy; Billhot, M.; Carmoi, T.

doi:10.1016/j.revmed.2015.03.202

Cited by 1 publication

(5 citation statements)

References 2 publications

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“…Table 2 summarizes the twenty cases found. [2][3][4][5][6][7][8][9][10][11][12][13][14][15] Like our report, the majority aged 65 years or older. [2][3][4][6][7][8][9][10][11][12]14,15 Symptom onset often occurred between the third and seventh day of ertapenem exposure.…”

Section: Discussionsupporting

confidence: 74%

“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15] Like our report, the majority aged 65 years or older. [2][3][4][6][7][8][9][10][11][12]14,15 Symptom onset often occurred between the third and seventh day of ertapenem exposure. [2][3][4][5][6][7]9,11,12,14,15 In one report symptoms manifested after 42 days of exposure.…”

Section: Discussionsupporting

confidence: 74%

“…Glomerular filtration rate was inferior to 30 mL/kg/1.73 m 2 in nine cases. [2][3][4]7,9,12,14 Our patient's renal function oscillated, reaching near dose reduction cut-off when applying Cockcroft-Gault formula (Table 1). Authors expressed concern about newer equations undervaluing renal impairment when compared to classical ones in elder patients.…”

Section: Discussionmentioning

confidence: 91%

“…After drug discontinuation, it took between 2 to 14 days for the symptoms to regress. [3][4][5][6][7][8][9][10][11][13][14][15] In one case, ertapenem was not interrupted and cognitive dysfunction lasted 21 days after antibiotic course completion. 12 Although no report culminated in patient death, two cases required intensive care.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][6][7][8][9][10][11][12]14,15 Symptom onset often occurred between the third and seventh day of ertapenem exposure. [2][3][4][5][6][7]9,11,12,14,15 In one report symptoms manifested after 42 days of exposure. 10 Unlike ertapenem-induced seizure cases, in which a past history of epilepsy, dementia, cerebrovascular disease or head trauma is often required, hallucination cases do not required such medical history.…”

Section: Discussionmentioning

confidence: 99%

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Ertapenem-Induced Delirium

Bilreiro

Correia

2022

Gaz Med

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Neurotoxicity is an unusual iatrogenic effect associated with carbapenems, typically manifested as seizures or hyperactive delirium. We present an 89-year-old female patient with a medical history of hypertension and chronic kidney disease who was admitted for acute tracheobronchitis and anemia related to diverticular disease. As a complication, she developed acute cystitis caused by extended spectrum ß-lactamases producing Klebsiella pneumoniae, so intravenous ertapenem was started. On the second day of antibiotic therapy, the patient manifested visual hallucinations followed by an inattentive and lethargic state suggestive of a hypoactive delirium. An ertapenem-induced neurotoxicity was suspected. Upon substitution by meropenem, the patient improved, and symptom reversal occurred after 72 hours. We present a review of ertapenem-induced hallucinations and address pharmacokinetics aspects namely renal dysfunction and hypoalbuminemia that could potentiate encephalopathy. Although rare, clinicians should be aware of non-seizure ertapenem related neurotoxicity. Ready recognition can lead to rapid improvement and prevent dire outcomes.

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