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Clinical and electroencephalographic assessment of cefepime during treatment of nosocomial infections in neurological patients
- Source :
- Central nervous system agents in medicinal chemistry. 11(3)
- Publication Year :
- 2011
-
Abstract
- Objective: Cefepime neurotoxicity usually occurs in patients with renal impairment. The aim of this study was to evaluate the neurotoxicity of cefepime administered by continuous intravenous infusion during treatment of nosocomial infections in neurological patients with normal renal function. Methods: This was an open pilot study of neurological patients with infections caused by cefepime sensitive bacteria. Patients had baseline neurological assessment and electroencephalogram (EEG). Cefepime plasma concentrations were determined 48 hours after infusion was initiated and at end of treatment (EOT). Results: Eleven patients were included. These were diagnosed with a brain tumor (9), cerebrovascular disease (1) and polyneuropathy (1). Infections were surgical site infection in 5, clinically defined nosocomial pneumonia in 4, and bacterial meningitis associated to postoperative CSF fistula in 2. Gram-negative organisms were isolated in 10 patients. Cefepime dose was 2 g/day in 9 patients and 4 g/day in 2. Mean cefepime plasma concentration at 48h was 13.6 ± 2.0 µg/mL (range 4.6 to 24.5 µg/mL), at EOT was 11.9 ± 1.8 µg/mL (range 3.0 to18.9 µg/mL ). EEG interpreted by two experts showed at baseline alpha background rhythm in 5 and theta-alpha rhythm in 6 patients. On EEG at EOT background rhythm was alpha in 4 and theta-alpha in 7, one patient presented isolated sharp and slow wave activity. No mental status changes or seizures occurred and all infections resolved. Conclusion: Significant EEG change was observed in 1of 11 patients. A preserved mental status may correlate with cefepime safety in neurological patients with normal renal function during cefepime treatment.
- Subjects :
- Adult
Male
Cefepime
Brain tumor
Pilot Projects
Microbial Sensitivity Tests
Electroencephalography
Young Adult
medicine
Humans
Infusions, Intravenous
Cross Infection
medicine.diagnostic_test
business.industry
General Neuroscience
Mental Disorders
Neurotoxicity
Middle Aged
medicine.disease
Anti-Bacterial Agents
Cephalosporins
Pneumonia
Neuropsychology and Physiological Psychology
Anesthesia
Plasma concentration
Molecular Medicine
Female
medicine.symptom
business
Myoclonus
Polyneuropathy
medicine.drug
Subjects
Details
- ISSN :
- 18756166
- Volume :
- 11
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Central nervous system agents in medicinal chemistry
- Accession number :
- edsair.doi.dedup.....1b6e2cb7ec499f43285a1d6a85b97f23