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1例头孢吡肟诱发的神经毒性:肾功能未起作用。

A Case of Cefepime-Induced Neurotoxicity: Renal Function Missing in Action.

作者信息

Lichak Brooke P, Lawal Omolara, Polimera Hyma V, Garg Ashwani, Kaur Gurwant

机构信息

Internal Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.

Neurology, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.

出版信息

Cureus. 2021 Feb 16;13(2):e13368. doi: 10.7759/cureus.13368.

Abstract

Cefepime is a renally excreted, fourth-generation cephalosporin used in the treatment of severe abdominal, skin, soft tissue, and urinary tract infections due to its broad-spectrum coverage. Cefepime-induced neurotoxicity is a rare but serious side effect that has increased in recent years likely due to increased antibiotic use, increased drug resistance, and increased symptom recognition. While decreased glomerular filtration rate is an important risk factor for developing elevated serum cefepime levels, recent literature has suggested that a significant proportion of patients with normal renal function can also develop neurotoxicity from cefepime. Here, we present a case of cefepime-induced neurotoxicity to demonstrate the importance of monitoring mental status changes in all patients being treated with cefepime.

摘要

头孢吡肟是一种经肾脏排泄的第四代头孢菌素,因其广谱抗菌作用而用于治疗严重的腹部、皮肤、软组织及尿路感染。头孢吡肟所致神经毒性是一种罕见但严重的副作用,近年来可能由于抗生素使用增加、耐药性增加以及症状识别增加而有所增多。虽然肾小球滤过率降低是血清头孢吡肟水平升高的一个重要危险因素,但最近的文献表明,相当一部分肾功能正常的患者也可能因头孢吡肟而发生神经毒性。在此,我们报告一例头孢吡肟所致神经毒性病例,以证明对所有接受头孢吡肟治疗的患者监测精神状态变化的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e63/7971718/cc047586c391/cureus-0013-00000013368-i01.jpg

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