The Trend of Cefepime-Induced Neurotoxicity: A Systematic Review

Area of Science:

• Pharmacology
• Neurology
• Infectious Diseases

Background:

• Increased cefepime use driven by concerns over vancomycin and Zosyn nephrotoxicity.
• Cefepime, while effective, carries a risk of neurotoxicity.
• Growing need to understand cefepime-induced neurotoxicity trends.

Purpose of the Study:

• To systematically review and analyze the trend of cefepime-induced neurotoxicity over the past decade.
• To identify patient demographics, indications, and risk factors associated with cefepime neurotoxicity.
• To evaluate cefepime dosing practices in patients with renal impairment.

Main Methods:

• Systematic review of online medical literature.
• Inclusion of 46 articles reporting 73 cases of cefepime-induced neurotoxicity.
• Analysis of case reports from 2013 to 2022.

Main Results:

• A consistent rise in reported cefepime neurotoxicity cases from 2013 to 2022.
• Patients aged 65+ comprised 52% of neurotoxicity cases.
• Common indications: bone/joint infections, UTIs, pneumonia; frequent lack of renal dose adjustment in impaired patients.

Conclusions:

• Cefepime neurotoxicity is an increasing concern, especially in the elderly.
• Inadequate renal dose adjustment is a significant risk factor.
• Optimizing cefepime dosing in renal impairment is essential for patient safety.