Meropenem delirium: a previously unrecognized neurologic side effect

Munoz-Gomez, Sigridh; Gran, Arthur; Cunha, Burke A.

doi:10.1179/1973947814y.0000000179

Cited by 11 publications

(6 citation statements)

References 5 publications

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“…Previous studies have suggested that the pathophysiology of quinolones and carbapenem-associated encephalopathy is associated with a disturbance of gamma-aminobutyric acid-ergic (GABAergic) interneurons. They affect the central nervous system mainly by inhibiting GABA receptors interfering with inhibitory neurotransmission and enhancing bursts of excitatory neurons, which is concentration-dependent ( Hori and Shimada, 1993 ; Munoz-Gomez et al, 2015 ). Our results also suggested that the use of propofol, midazolam, and opioids was found to be more likely observed in SAE patients.…”

Section: Discussionmentioning

confidence: 99%

Mechanical Learning for Prediction of Sepsis-Associated Encephalopathy

Zhao

Wang

et al. 2021

Front. Comput. Neurosci.

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Objective: The study aims to develop a mechanical learning model as a predictive model for predicting the appearance of sepsis-associated encephalopathy (SAE).Materials and Methods: The prediction model was developed in a primary cohort of 2,028 sepsis patients from June 2001 to October 2012, retrieved from the Medical Information Mart for Intensive Care (MIMIC III) database. Least absolute shrinkage and selection operator (LASSO) regression model was used for data dimension reduction and feature selection. The model was developed using multivariable logistic regression analysis. The performance of the nomogram has been evaluated in terms of calibration, discrimination, and clinical utility.Results: There were nine particular features in septic patients that were significantly associated with SAE. Predictors of individualized prediction nomograms included age, rapid sequential evaluation of organ failure (qSOFA), and drugs including carbapenem antibiotics, quinolone antibiotics, steroids, midazolam, H2-antagonist, diphenhydramine hydrochloride, and heparin sodium injection. The area under the curve (AUC) was 0.743, indicating good discrimination. The prediction model showed calibration curves with minor deviations from the ideal predictions. Decision curve analysis (DCA) suggested that the nomogram was clinically useful.Conclusion: We propose a nomogram for the individualized prediction of SAE with satisfactory performance and clinical utility, which could aid the clinician in the early detection and management of SAE.

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Section: Discussionmentioning

confidence: 99%

Mechanical Learning for Prediction of Sepsis-Associated Encephalopathy

Zhao

Wang

et al. 2021

Front. Comput. Neurosci.

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“…[7][8][9][10][11][12][13] Relief from delirium symptoms was seen within 1 to 3 days from discontinuation of the offending agent. [9][10][11][12] Previous case reports also describe use of antipsychotics to treat delirium from Yes (+2 points) 3. Did the adverse event improve when the drug was discontinued, or a specific antagonist was administered?…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Discussionmentioning

confidence: 99%

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Meropenem-Induced Delirium in a Hemodialysis-Dependent Adolescent Girl

Tabulov

Montoya

Panzarino

2023

Clin Pediatr (Phila)

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“…There are few case reports of neurotoxicity following carbapenem administration outside of those involving seizures and none involving patients with MS, a patient population with the potential to have an increased risk for developing neurotoxicity. 5,[10][11][12][13] Here, we present a novel case of a patient with MS who developed spasticity and encephalopathy following the administration of meropenem and ertapenem to treat a UTI.…”

Section: Introductionmentioning

confidence: 99%

Probable Encephalopathy and Spasticity in a Multiple Sclerosis Patient Following Carbapenem Administration: A Case Report and Brief Literature Review

Klimko

Sanders

Johns

2021

Journal of Pharmacy Practice

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Purpose: The purpose of this case report is to describe spasticity and encephalopathy that developed in a multiple sclerosis patient following carbapenem administration. Summary: A 55-year-old female with multiple sclerosis developed spasticity and encephalopathy within 24 hours of meropenem and ertapenem administration. This was the second time that she had developed encephalopathy following carbapenem administration. The patient gradually recovered over four days following discontinuation of carbapenem therapy. Conclusion: Carbapenem neurotoxicity, a well-documented adverse effect, has been linked to several risk factors, including central nervous system lesions. Despite this, there is little evidence describing the risk of neurotoxicity in patients with multiple sclerosis. It is important to understand the potential adverse effects of carbapenems in specific patient populations to help guide appropriate treatment of infections.

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Meropenem delirium: a previously unrecognized neurologic side effect

Cited by 11 publications

References 5 publications

Mechanical Learning for Prediction of Sepsis-Associated Encephalopathy

Mechanical Learning for Prediction of Sepsis-Associated Encephalopathy

Meropenem-Induced Delirium in a Hemodialysis-Dependent Adolescent Girl

Probable Encephalopathy and Spasticity in a Multiple Sclerosis Patient Following Carbapenem Administration: A Case Report and Brief Literature Review

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