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Intraventricular nafcillin-induced seizures in a neonate

B S Brozanski1, M S Scher, A L Albright

  • 1Department of Pediatrics, Magee-Womens Hospital, Pittsburgh, PA 15213.

Insights

Intraventricular nafcillin in a premature infant caused seizures. This highlights the critical need for electroencephalographic monitoring during intraventricular antibiotic therapy for shunt infections.

Area of Science:

  • Neonatal neurology
  • Pediatric infectious diseases
  • Neurocritical care

Background:

  • Cerebrospinal fluid (CSF) shunt infections are serious complications in infants.
  • Treatment typically involves intravenous and intraventricular antibiotics.

Observation:

  • A premature infant receiving intraventricular nafcillin developed seizures.
  • This adverse event occurred despite standard antibiotic treatment protocols.

Findings:

  • Intraventricular nafcillin administration was temporally associated with seizure activity.
  • The specific mechanism linking intraventricular nafcillin to seizures in neonates requires further investigation.

Implications:

  • Electroencephalographic (EEG) monitoring is crucial for neonates receiving intraventricular antibiotics.
  • This case underscores potential neurotoxicity of antibiotics administered directly into the cerebrospinal fluid.
  • Clinical practice guidelines may need updates regarding neurophysiologic monitoring during intraventricular antibiotic therapy.

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