Cefepime-Associated Neurotoxicity in a Pediatric Patient With Stage V Chronic Kidney Disease

• DOI: 10.1177/08971900221125000
• Publication Date: 2022-09-09T05:42:21Z
• Authors: Horace Rhodes Ham...; Kathryn Pavia; Sonya Tang Girdwood; Danielle Lazear; John Michael Taylor; Stefanie Benoit
• Keywords: Cefepime; Neurotoxicity; Discontinuation; Bacteremia

Background: Studies in adult patients suggest cefepime can cause neurotoxicity, including disorientation, seizures, and coma, particularly when present at high concentrations. Patients with underlying kidney dysfunction or central nervous system anomalies are risk. There is a relative paucity of pediatric literature on the neurotoxic effects cefepime. Case Report: Herein reported case 2-year-old patient chronic disease receiving for Serratia marcescens bacteremia who experienced agitation, tremor, inconsolability setting an elevated trough that improved discontinuation alone. Conclusions: Pediatric acute risk cefepime-related neurologic changes. Therapeutic drug monitoring baseline abnormalities may help inform appropriate antimicrobial dosing avoidance toxicity.