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Cefepime-induced encephalopathy in end-stage renal disease patients
- Source :
- Journal of the neurological sciences. 376
- Publication Year :
- 2017
-
Abstract
- Objectives Impaired renal function is a risk factor for cefepime (CFPM)-induced encephalopathy (CFPMIE) in patients treated with CFPM; dose-titration to renal function is recommended to prevent CFPMIE. However, available evidence on the incidence of CFPMIE or preventive efficacy of dose adjustment against CFPMIE in end-stage renal disease (ESRD) patients is limited. Methods Single-centre, retrospective observational study. We reviewed consecutive in-hospital adult patients treated with adjusted-dose of CFPM in the period between September 2012 and September 2016, and assessed the CFPMIE in ESRD patients treated with adjusted-dose of CFPM. Results Out of 422 eligible patients, 6 patients (1.4%) were diagnosed with CFPMIE. The incidence of CFPMIE in ESRD patients was 7.5% (5/67). Among ESRD patients, pre-existing central nervous system (CNS) morbidity was significantly associated with the risk of CFPMIE. CFPMIE occurred in ESRD patients regardless of daily dose, and even with 0.5 g/day of CFPM. Conclusions Pre-existing CNS morbidity may be associated with an increased risk of CFPMIE in ESRD patients. No significant association was observed between CFPM dose and incidence of CFPMIE in ESRD patients, and future investigation on the safer dose-adjustment strategy in ESRD patients is required for achieving balance between successful infectious treatment and reducing CFPMIE.
- Subjects :
- Male
medicine.medical_specialty
Cefepime
Encephalopathy
Renal function
Disease
Comorbidity
urologic and male genital diseases
End stage renal disease
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Medicine
Humans
Risk factor
Aged
Retrospective Studies
Brain Diseases
Dose-Response Relationship, Drug
business.industry
Incidence (epidemiology)
Incidence
030208 emergency & critical care medicine
Retrospective cohort study
Middle Aged
medicine.disease
Anti-Bacterial Agents
Cephalosporins
Neurology
Anesthesia
Kidney Failure, Chronic
Female
Neurology (clinical)
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 18785883
- Volume :
- 376
- Database :
- OpenAIRE
- Journal :
- Journal of the neurological sciences
- Accession number :
- edsair.doi.dedup.....860138ce03651b0a4733cccdee399478