Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, #201 Sec. 2 Shih-Pai Road, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2011 Feb;74(2):87-90. doi: 10.1016/j.jcma.2011.01.017.
Encephalopathy or neurotoxicity can occur with cefepime use in patients with impaired or relatively normal renal function. However, few articles have examined the relationship between cefepime's adverse effects and peritoneal dialysis. Here, we report the case of an 80-year-old woman with chronic renal failure on peritoneal dialysis that developed agitation, confusion, and dystonia after cefepime administration for 2 days. The clinical and electroencephalographic abnormalities improved after discontinuation the drug. We review the role of peritoneal dialysis in the development of cefepime-induced encephalopathy. Peritoneal dialysis is a less efficient way to eliminate cefepime than hemodialysis. Short-term hemodialysis might be considered to facilitate elimination of the drug in patients who have developed neurotoxicity.
脑病或神经毒性可发生在有肾功能损害或相对正常的患者中使用头孢吡肟。然而，很少有文章研究头孢吡肟的不良反应与腹膜透析之间的关系。在这里，我们报告了一例 80 岁女性慢性肾衰竭患者在接受头孢吡肟治疗 2 天后出现激越、意识模糊和肌张力障碍的病例。药物停用后，临床和脑电图异常改善。我们回顾了腹膜透析在头孢吡肟诱导的脑病发展中的作用。与血液透析相比，腹膜透析清除头孢吡肟的效率较低。对于已发生神经毒性的患者，可考虑短期血液透析以促进药物清除。
