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Cefepime induced acute interstitial nephritis--a case report.
Kathy Mac1, Ruchir Chavada2, Sharon Paull3
1Department of Renal Medicine, South Western Sydney Local Health District, Liverpool, NSW, 2170, Australia. kmac0605@gmail.com.
This case report details a rare instance of acute interstitial nephritis, a form of acute kidney injury, caused by the antibiotic cefepime. Physicians should monitor kidney function in patients receiving prolonged cefepime therapy.
Area of Science:
- Nephrology
- Infectious Diseases
- Pharmacology
Background:
- Nephrotoxicity is a known risk with beta-lactam antibiotics, including cephalosporins.
- Cefepime, a fourth-generation cephalosporin, is widely used with a generally favorable safety profile.
- While cefepime-induced neurotoxicity is documented, acute interstitial nephritis has not been previously reported.
Observation:
- A 62-year-old female developed acute kidney injury after four weeks of intravenous cefepime for mastoiditis and temporal bone osteomyelitis.
- Renal biopsy confirmed acute interstitial nephritis as the cause of kidney injury.
- No other nephrotoxic medications were administered concurrently.
Findings:
- This is the first reported case of acute interstitial nephritis attributed to cefepime.
- Cefepime cessation led to partial improvement in renal function with conservative management.
- The patient's urine analysis showed non-nephrotic range proteinuria without cellular casts.
Implications:
- Cefepime, despite its perceived safety, can rarely cause nephrotoxicity, specifically acute interstitial nephritis.
- Healthcare providers must remain vigilant for potential renal adverse effects of cefepime.
- Close monitoring of renal function is crucial for patients undergoing extended cefepime treatment.
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