Department of Internal Medicine, Division of Nephrology, King Fahd Hospital of the University, Alkhobar; Department of Internal Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Diaverum Al-Majdoi Dialysis Center, Eastern Province, Saudi Arabia.
Saudi J Kidney Dis Transpl. 2020 Nov-Dec;31(6):1427-1431. doi: 10.4103/1319-2442.308364.
Dosage adjustment of meropenem is usually recommended in hemodialysis (HD) patients and about 30% of meropenem is cleared during regular HD sessions. However, most of the published trials excluded patients on regular HD. Little is known about the accurate dosage of meropenem needed to avoid central nervous system toxicity. Herein, we report a 65-year-old Saudi female, a known case of end-stage renal disease on regular HD, who was admitted because of pyelonephritis and started on meropenem in the recommended dose according to cultures and sensitivity. She developed tonic-clonic convulsions after the 7 dose. Seizures were completely aborted after discontinuation of the offending drug. The recommended dosage of 500 mg daily in HD patients may still be too high particularly in Asian patients owing to their relatively small body mass index.
美罗培南在血液透析（HD）患者中通常需要进行剂量调整，大约 30%的美罗培南在常规 HD 治疗中被清除。然而，大多数已发表的试验都排除了接受常规 HD 治疗的患者。对于避免中枢神经系统毒性所需的美罗培南准确剂量知之甚少。在此，我们报告了一名 65 岁的沙特女性，她患有终末期肾病，需要进行常规 HD 治疗，因肾盂肾炎入院，并根据培养和药敏结果给予美罗培南推荐剂量。在第 7 剂后，她出现强直-阵挛性抽搐。停用有问题的药物后，癫痫完全停止。由于亚洲患者的体重指数相对较小，因此对于 HD 患者，每日 500 毫克的推荐剂量可能仍然过高，特别是在亚洲患者中。
