Ceftazidime-related neurotoxicity in a patient with renal impairment: a case report and literature review.
Infection
; 52(3): 1113-1123, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38305827
ABSTRACT
PURPOSE:
We present the case of a 67-year-old woman with severely reduced renal clearance suffering from ceftazidime-induced encephalopathy. Subsequently, we search the literature to review and describe the neurotoxicity of ceftazidime.METHODS:
A search string was developed to search PubMed for relevant cases from which relevant information was extracted. Using the collected data a ROC analysis was performed in R to determine a neurotoxicity threshold.RESULTS:
Our patient suffered from progressive loss of consciousness and myoclonic seizures, with improvements noted a few days after discontinuation of treatment. The dose was not appropriately reduced to take into account her reduced renal function. The highest ceftazidime concentration recorded was 234.9 mg/mL. Using the Naranjo score we found a probable relationship between our patient's encephalopathy and ceftazidime administration. In the literature we found a total of 32 similar cases, most of which also had some form of renal impairment. Using our collected data and ceftazidime concentrations provided in the literature, a ROC analysis provided a neurotoxicity threshold of 78 mg/L for ceftazidime neurotoxicity.CONCLUSION:
Ceftazidime-related neurotoxicity is a known issue, especially in patients with severe renal impairment. Yet no concrete toxicity threshold has been reported so far. We propose the first toxicity threshold for ceftazidime of 78 mg/L. Future prospective studies are needed to validate and optimize the neurotoxicity threshold as upper limit for ceftazidime therapeutic drug monitoring.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Ceftazidima
/
Síndromes Neurotóxicas
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Antibacterianos
Tipo de estudo:
Observational_studies
Limite:
Aged
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Female
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Humans
Idioma:
En
Revista:
Infection
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Bélgica