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Imipenem-Cilastatin-Induced Seizures: A Case Report
Ghaith Aloui1, Baraa Ben Houria1, Mohamed Ali Yousfi1,2
1Department of Pharmacy, Main Military Training Hospital of Tunis, Tunis, Tunisia.
Current Drug Safety
|October 8, 2024
Summary
Imipenem-cilastatin can rarely cause seizures, even in younger patients. Prompt recognition and drug discontinuation are crucial for effective management and improved patient outcomes in cases of antibiotic-induced epilepsy.
Area of Science:
- Neurology
- Infectious Diseases
- Pharmacology
Background:
- Imipenem-cilastatin is a carbapenem antibiotic frequently used for severe bacterial infections.
- While effective, it carries a rare risk of central nervous system toxicity, including seizures.
- This case highlights a seizure event in a 20-year-old patient.
Observation:
- A 20-year-old male presented with febrile status epilepticus and acute respiratory distress syndrome.
- Despite initial anti-epileptic treatment, recurrent seizures prompted a review of the antibiotic regimen.
- Imipenem-cilastatin was suspected, and its discontinuation led to neurological stability.
Findings:
- The causality assessment indicated plausible causality (I3) for imipenem-cilastatin-induced seizures.
- Literature review confirmed prior reports, often in elderly patients or with higher dosages.
- This case extends the observation to a younger patient.
Implications:
- Clinicians must remain vigilant for imipenem-cilastatin-induced seizures, especially in patients with neurological vulnerabilities.
- Prompt recognition and management, including drug discontinuation, are vital for patient care.
- Personalized antibiotic selection balancing efficacy and potential adverse effects is recommended for optimal outcomes.
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