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Cefepime-Induced Encephalopathy in a Tertiary Medical Center in Korea

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Author(s)
Ji-Ye JeonYong Won ChoHye-Jin Moon
Keimyung Author(s)
Cho, Yong WonMoon, Hye Jin
Department
Dept. of Neurology (신경과학)
Journal Title
Journal of Clinical Neurology
Issued Date
2020
Volume
16
Issue
3
Keyword
encephalopathycefepimeepilepsyincidenceelectroencephalography
Abstract
Background and Purpose:
Cefepime is a widely used fourth-generation cephalosporin. It is commonly used as a first-line antibiotic to treat various infectious diseases such as hospital-acquired pneumonia, urinary tract infections, and bacterial meningitis. The primary outcome of this study was the development of cefepime-induced encephalopathy (CIE) at a tertiary medical center in Korea. We also aimed to describe the clinical features of CIE.

Methods:
We enrolled 1,793 consecutive patients treated with cefepime. The CIE group included 44 patients who experienced altered consciousness after receiving cefepime without any other obvious cause and showed full recovery after stopping cefepime. This study collected demographic data, laboratory findings, and clinical data including the cause of infection, duration for onset of altered consciousness, duration of cefepime treatment, dosage of cefepime, duration of recovering consciousness after stopping cefepime, sequelae after encephalopathy, and electroencephalography data.

Results:
Forty-four (2.5%) patients were included in the CIE group. The age was significantly higher in the CIE group than in the control group (71.2±10.8 years vs. 64.7±16.1 years, mean±standard deviation; p=0.007), and females constituted a significantly large proportion in the CIE group (27 of 44, 61.4%). The CIE group had higher blood urea nitrogen (34.7±22.6 mg/dL vs. 23.0±17.5 mg/dL, p<0.001) and creatinine (2.2±2.5 mg/dL vs. 1.1±1.3 mg/dL, p<0.001), and lower estimated glomerular filtration rate (eGFR) (56.3±46.0 mL/min/1.73 mm2 vs. 98.8±66.3 mL/min/1.73 mm2,p<0.001). Multivariate analysis showed that only eGFR was significantly related to CIE.

Conclusions:
The incidence of CIE was 2.5% in this study. It is essential to consider the possibility of CIE occurring, especially in patients with lower values of eGFR and dialysis.
Keimyung Author(s)(Kor)
조용원
문혜진
Publisher
School of Medicine (의과대학)
Citation
Ji-Ye Jeon et al. (2020). Cefepime-Induced Encephalopathy in a Tertiary Medical Center in Korea. Journal of Clinical Neurology, 16(3), 408–415. doi: 10.3988/jcn.2020.16.3.408
Type
Article
ISSN
2005-5013
Source
https://thejcn.com/search.php?where=aview&id=10.3988/jcn.2020.16.3.408&code=0145JCN&vmode=FULL
DOI
10.3988/jcn.2020.16.3.408
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42850
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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