Ertapenem neurotoxicity in patients with kidney damage: A case report

Abstract

Ertapenem, a member of the carbapenem group of antibiotics, is a broad-spectrum antibiotic that is effective against multidrug-resistant gram-positive and gram-negative infections. In patients with acute or chronic kidney damage, one of the most serious side effects of ertapenem is neurotoxicity. Various clinical conditions such as seizures, hallucinations, delirium, confusion, and nystagmus may occur. Previous history of cerebral pathologies is a known risk factor for ertapenem-associated neurotoxicity. Immediate discontinuation of treatment is required. Although the symptoms usually resolve rapidly, cases with longer duration of symptoms have also been reported. Close monitoring of neurological status in such patients is essential.

Meropenem-Induced Delirium in a Hemodialysis-Dependent Adolescent Girl

“…The most common management strategy to relieve carbapenem-induced delirium was discontinuation of the offending agent after the appearance of delirium 2 to 8 days from start of therapy. 7-13 Relief from delirium symptoms was seen within 1 to 3 days from discontinuation of the offending agent. 9-12 Previous case reports also describe use of antipsychotics to treat delirium from ertapenem.…”

“…9-12 Previous case reports also describe use of antipsychotics to treat delirium from ertapenem. 7,10,12 Switching to an alternative antibiotic drug class 7,11 or an alternative carbapenem 8,13 is described as well. Ertapenem is 30% dialyzable.…”