| Clinical and Electroencephalographic Assessment of Cefepime During Treatment of Nosocomial Infections in Neurological Patients. | |
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MedLine Citation:
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PMID: 21919869 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Objective: Cefepime neurotoxicity usually occurs in patients with renal impairment. The aim of this study was to evaluate the neurotoxicity of cefepime administered by continuous intravenous infusion during treatment of nosocomial infections in neurological patients with normal renal function. Methods: This was an open pilot study of neurological patients with infections caused by cefepime sensitive bacteria. Patients had baseline neurological assessment and electroencephalogram (EEG). Cefepime plasma concentrations were determined 48 hours after infusion was initiated and at end of treatment (EOT). Results: Eleven patients were included. These were diagnosed with a brain tumor (9), cerebrovascular disease (1) and polyneuropathy (1). Infections were surgical site infection in 5, clinically defined nosocomial pneumonia in 4, and bacterial meningitis associated to postoperative CSF fistula in 2. Gram-negative organisms were isolated in 10 patients. Cefepime dose was 2 g/day in 9 patients and 4 g/day in 2. Mean cefepime plasma concentration at 48h was 13.6 ± 2.0 µg/mL (range 4.6 to 24.5 µg/mL), at EOT was 11.9 ± 1.8 µg/mL (range 3.0 to18.9 µg/mL). EEG interpreted by two experts showed at baseline alpha background rhythm in 5 and theta-alpha rhythm in 6 patients. On EEG at EOT background rhythm was alpha in 4 and theta-alpha in 7, one patient presented isolated sharp and slow wave activity. No mental status changes or seizures occurred and all infections resolved. Conclusion: Significant EEG change was observed in 1of 11 patients. A preserved mental status may correlate with cefepime safety in neurological patients with normal renal function during cefepime treatment. |
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Authors:
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Susana Dimas Alvarez; Maria Del Carmen; Fernández Gonzalez Aragon; Alvaro Moreno; Francisca Palomares Alonso; Helgi Jung Cook; Graciela Cárdenas; José Luis Soto-Hernández |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-9-15 |
Journal Detail:
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Title: Central nervous system agents in medicinal chemistry Volume: - ISSN: 1875-6166 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-9-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101269163 Medline TA: Cent Nerv Syst Agents Med Chem Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Infectious Diseases Department, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, México City, Mexico joseluis_sotohernandez@yahoo.com. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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