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[Penicillin-induced encephalopathy]

P Trunet, A M Bouvier, G Otterbein

    La Nouvelle Presse Medicale
    |May 15, 1982
    PubMed
    Summary
    This summary is machine-generated.

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    High doses of intravenous penicillin can cause severe encephalopathy in patients with kidney failure. Symptoms include decreased consciousness, seizures, and coma, with some patients recovering after drug withdrawal.

    Area of Science:

    • Neurology
    • Nephrology
    • Pharmacology

    Background:

    • Penicillin antibiotics are widely used but can have neurotoxic effects.
    • Uraemic patients have impaired drug clearance, increasing the risk of toxicity.
    • Intravenous administration of penicillin may lead to higher peak serum concentrations.

    Observation:

    • Five cases of encephalopathy in uraemic patients receiving intravenous penicillin (penicillin G sodium or oxacillin) are presented.
    • Clinical manifestations included decreased consciousness, myoclonic jerks, seizures, and coma.
    • Cerebrospinal fluid and CT scans were normal, while EEG showed diffuse abnormalities.

    Findings:

    • High blood levels of penicillin confirmed the diagnosis of penicillin-induced encephalopathy.
    • Three patients recovered following cessation of the antibiotic treatment.

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  • Two patients experienced fatal outcomes due to refractory status epilepticus and coma.

    • Implications:

    • Careful dosing and monitoring of intravenous penicillin are crucial in uraemic patients.
    • Penicillin-induced neurotoxicity is a potentially reversible condition if diagnosed and managed promptly.
    • This highlights the importance of considering drug toxicity in uraemic patients presenting with neurological symptoms.