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Renal failure is a risk factor for cefepime-induced encephalopathy
E O Garces1, M F Andrade de Anzambuja, D da Silva
1Post-Graduation Program in Medical Sciences, Universidade Federal de Rio Grande do Sul, Porto Alegre, RS - Brazil.
Journal of Nephrology
|July 25, 2008
Summary
Cefepime antibiotic can cause encephalopathy, particularly in patients with kidney issues. This study found a 1% incidence, with impaired glomerular filtration rate being a significant risk factor for cefepime-induced encephalopathy.
Area of Science:
- Neurology
- Nephrology
- Infectious Diseases
Background:
- Cefepime is a broad-spectrum antibiotic with increasing reports of associated encephalopathy.
- Encephalopathy is primarily observed in patients with compromised renal function.
- Understanding cefepime-induced encephalopathy incidence and risk factors is crucial for patient safety.
Purpose of the Study:
- To determine the incidence of cefepime-induced encephalopathy.
- To identify potential risk factors associated with its development.
- To investigate the relationship between renal function and cefepime neurotoxicity.
Main Methods:
- A prospective cohort study involving 498 patients treated with cefepime.
- Exclusion of other metabolic causes for suspected encephalopathy.
- Diagnosis supported by electroencephalographic (EEG) tests performed during and after cefepime treatment.
Main Results:
- A cumulative incidence of approximately 1% (5 out of 498 patients) for cefepime-induced encephalopathy was observed.
- All 5 cases of encephalopathy occurred in patients with a glomerular filtration rate (GFR) below 60 ml/min.
- Patients with encephalopathy had a significantly lower mean GFR (17.20 ml/min) compared to those without (32.59 ml/min) (p=0.025).
Conclusions:
- The occurrence of cefepime-induced encephalopathy is strongly associated with the degree of renal impairment.
- Severity of glomerular filtration impairment is a key risk factor.
- Clinical monitoring of renal function is essential in patients receiving cefepime.
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