Cefepime- and cefixime-induced encephalopathy in a patient with normal renal function

I read with interest the article by Capparelli et al.1 reporting the case of an elderly patient with normal renal function presenting with recurrent episodes of cephalosporin-induced encephalopathy. EEG showed a diffuse slowing without evidence of ongoing epileptiform activity. These authors hypothesized that this neurologic adverse effect could be secondary to the modification that these drugs may produce on the cerebral concentrations of gamma-aminobutyric acid (GABA). The existence of acute confusional states associated with the use of cephalosporins in subjects with variable degrees of renal failure …