Prospective assessment of breakthrough infections and neurotoxicity and their association with cefepime trough concentrations in patients with febrile neutropenia

Gijsen, Matthias; Bekkers, Britt; Maertens, Johan; Lagrou, Katrien; Desmet, Stefanie; Dreesen, Erwin; Peetermans, Willy; Debaveye, Yves; Spriet, Isabel

doi:10.1016/j.ijantimicag.2021.106472

Cited by 11 publications

(1 citation statement)

References 25 publications

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“…First, the duration of cefepime administration in this study was around 5 days compared to the other studies having relatively longer times to detect the adverse effects [15,22,40]. Second, the therapeutic drug monitoring (TDM) might appeal given the observed association between higher levels and neurotoxicity [41][42][43][44][45][46], however, it was not available at our institution. The neurotoxicity event in our sample was low.…”

Section: Discussionmentioning

confidence: 98%

Cefepime-induced neurotoxicity in non-critically ill medical patients: a retrospective cohort study

2024

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Studies had reported the association between cefepime and neurotoxicity. The neurotoxicity incidence was well documented regarding the intensive care unit (ICU). This study was aimed to evaluate the incidence and characteristics of neurotoxicity caused by cefepime in the medical patients. A retrospective study was conducted on the medical patients treated with cefepime. Patients having received cefepime were eligible for the screening. Exclusion criteria were as follows: admitted in ICU, Alzheimer’s disease, admitted with the altered mental status because of any cause or epilepsy history. Naranjo adverse event scale described the probability of adverse events in suspected cases and categorized as definite, probable, possible and doubtful. A total of 601 patients were screened wherein 93 met the inclusion criteria. The mean age (±standard deviation (SD)) was 56 years (±17). The patients’ majority was male (66%) with the normal kidney function (73%). Common comorbidities included hypertension (60%) and diabetes (40%). Only 2 patients (2%) had developed neurological symptoms. The cases were carefully evaluated where one was doubtful and the other possibly had cefepime-induced neurotoxicity. The neurotoxicity incidence among medical patients was low, and might relate to the disease states affecting central nervous system. Hence, a careful evaluation of other possible causes for neurological symptoms deemed necessary while being on cefepime therapy.

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