• PDF / 171,142 Bytes
• 1 Pages / 595.245 x 841.846 pts (A4) Page_size
• 48 Downloads / 180 Views

DOWNLOAD

REPORT

---

1 S

Neurotoxicity and phlebitis: 5 case reports In a retrospective study involving 1000 patients, 5 patients, including 2 women and 2 men aged 81–93 years [not all ages and sexes stated], were described, who developed neurotoxicity or phlebitis during antibiotic treatment with cefepime or ceftriaxone [not all dosages, durations of treatments to reactions onsets and outcomes stated]. A 93-year-old man had a history of intracranial haemorrhage and seizures secondary to hyponatraemia. He had been receiving IV push of cefepime 1g every 8h and metronidazole for parotitis. Additionally, he had been receiving an unspecified anticoagulant and an unspecified anti-epileptic therapy. Following 23 doses of cefepime, he continued to have intermittent myoclonic jerking despite correction of hyponatraemia. As a result, cefepime-induced neurotoxicity was suspected. Therefore, cefepime was replaced with ciprofloxacin. The Naranjo Adverse Drug Reaction Probability Scale score was found to be 3, which indicated a possible relationship between cefepime and neurotoxicity. An 89-year-old woman had a history of encephalopathy, acute hypoxic respiratory failure, pneumonia and urinary tract infection (UTI). She had been receiving IV push of cefepime 1g every 24h for pneumonia and UTI and vancomycin for encephalopathy. Additionally, she had been receiving unspecified anticoagulant therapy and undergoing dialysis. Following 6 doses of cefepime (i.e. on day-6 of cefepime therapy), she developed altered mental status and cefepime was replaced with piperacillin/tazobactam in view of the cefepime-induced neurotoxicity. As a result, her altered mental status improved. The Naranjo Adverse Drug Reaction Probability Scale score was found to be 4, which indicated a possible relationship between cefepime and neurotoxicity. An 84-year-old man had increasing shortness of breath, cough and hypoxia. He had been receiving antibiotic treatment with IV push of cefepime 1g every 8h and azithromycin. Additionally, he had been receiving an unspecified anticoagulant and an unspecified corticosteroid. Following 3 doses of cefepime, he developed acute confusion and altered mental status. Considering the possibility of cefepime-induced neurotoxicity, cefepime was discontinued. The Naranjo Adverse Drug Reaction Probability Scale score was found to be 5, which indicated a probable relationship between cefepime and neurotoxicity. An 81-year-old woman had septic and cardiogenic shock and was obtunded in the setting of uraemia, fevers and sepsis. She had been receiving antibiotic treatment with IV push of cefepime every 12h. Additionally, she had been receiving an unspecified anticoagulant and an unspecified antihistaminic therapy. Subsequently, her renal function was found to be declined; however, the dose of cefepime was not adjusted for 3 days until dialysis was initiated. At the time of dialysis initiation, the frequency of cefepime was changed to every 24 hours. Following 12 doses of cefepime, she developed altered mental status, which was not improved with dialys