Tremor as a Rare Manifestation of Cefepime Neurotoxicity

Area of Science:

• Pharmacology
• Neuroscience
• Infectious Diseases

Background:

• Cefepime is a fourth-generation cephalosporin antibiotic with broad-spectrum activity against Gram-positive and Gram-negative bacteria.
• It is frequently prescribed for community-acquired pneumonia and urinary tract infections in inpatient settings.
• Known adverse effects include gastrointestinal issues, hypersensitivity reactions, and neurotoxicity, though specific manifestations vary.

Observation:

• An 88-year-old female presented with an acute change in mental status due to a urinary tract infection.
• Intravenous cefepime was administered, leading to the development of a low-frequency tremor within one day.
• The tremor resolved within three days of discontinuing cefepime treatment.

Findings:

• This case represents the first documented instance of tremor as a neurotoxic side effect associated with cefepime.
• While cefepime-induced neurotoxicity is recognized, tremor has not been previously reported as a manifestation.
• The temporal association suggests a causal link between cefepime administration and the onset of tremor.

Implications:

• Healthcare providers should consider tremor as a potential neurotoxic adverse effect of cefepime.
• Discontinuation of cefepime may be warranted if a tremor emerges shortly after initiating treatment.
• This finding expands the known spectrum of cefepime-associated neurotoxicity, necessitating increased clinical vigilance.