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Cefepime-induced encephalopathy

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Cefepime is a fourth-generation cephalosporin antibiotic widely used in clinical practice for various organ systems pathology treatment. The article describes the clinical observation of a patient who, 3 days after cefepime administration, had a decrease in the level of consciousness, regarded as encephalopathy. Cefepime-induced neurotoxicity is characterized by toxic encephalopathy, which manifests 2–6 days after the start of the treatment with this drug and disappears 1–3 days after its withdrawal. Electroencephalography (EEG) abnormalities include generalized periodic discharges (GPR) of triphasic morphology or a pattern corresponding to the criteria for non-convulsive status epilepticus (BSES). In our observation, the EEG recorded stimulus-induced GPRs of triphasic morphology with a frequency of 1.5 Hz; a test with intravenous administration of an antiepileptic drug (levetiracetam) was negative. A day after the withdrawal of cefepime, the patient’s level of consciousness returned to the initial level, and on the EEG periodic discharges completely regressed. Thus, cefepime may cause encephalopathy in patients with rhythmic or intermittent EEG activity, especially in the presence of a stimulus-induced component. In some cases, the use of cefepime may develop epileptic seizures and BSES.

About the Authors

T. N. Pushkar
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia
Russian Federation

Department of nervous diseases of Medical Faculty.

20, Delegatskaya St., Build. 1, Moscow 127473

Competing Interests:

There are no conflicts of interest

P. N. Vlasov
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia
Russian Federation

Pavel Nikolaevich Vlasov - Department of nervous diseases of Medical Faculty.

20, Delegatskaya St., Build. 1, Moscow 127473

Competing Interests:

There are no conflicts of interest

A. I. Belyakova-Bodina
Research Center of Neurology
Russian Federation

80, Volokolamskoye Shosse, Moscow 125367

Competing Interests:

There are no conflicts of interest

A. G. Broutian
Research Center of Neurology
Russian Federation

80, Volokolamskoye Shosse, Moscow 125367

Competing Interests:

There are no conflicts of interest


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For citations:

Pushkar T.N., Vlasov P.N., Belyakova-Bodina A.I., Broutian A.G. Cefepime-induced encephalopathy. Neurology, Neuropsychiatry, Psychosomatics. 2023;15(3):76-81. (In Russ.)

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)