Neurotoxicity by Cefepime: Case-Control Study

Cefepime에 의해 발생한 신경독성에 관한 환자대조군연구

  • Kang, Joong Koo (Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim, Soon Bae (Division of Nephrology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center)
  • 강중구 (울산대학교 의과대학, 서울아산병원 신경과) ;
  • 김순배 (울산대학교 의과대학, 서울아산병원 신장내과)
  • Received : 2014.11.21
  • Accepted : 2014.12.02
  • Published : 2014.12.31

Abstract

Background: Cefepime is a fourth-generation cephalosporin widely used for empiric treatment of severe infections. Neurotoxicity by cefepime have been reported due to γ-aminobutyric acid A receptor inhibition or other mechanisms. The aim of this study was to evaluate the risk factors for cefepime-induced neurotoxicity between group showing cefepime-induced neurotoxicity and group without neurotoxicity. Methods: From Jan 2005 to June 2010, a total of 2,461 patients (older than 20) who used cefepime were considered in this study. We compared patients who developed cefepime-induced neurotoxicity (patient group, n=21) to patients who had no cefepime-induced neurotoxicity (control group, n=31). We analyzed demographic, underlying diseases, and metabolic parameters before cefepime treatment and during cefepime treatment between the two groups. Statistical analysis was performed using SPSS 18 software. Results: Of the total 2461 patients, 21 (0.85%) were diagnosed with cefepime-induced neurotoxicity. Impaired glomerular filtration rate (GFR at 15-30 ml/min) before cefepime use were significantly (P<0.05) higher risk for developing cefepime-induced neurotoxicity in patient group compared to that in the control group. Age, sex, and other metabolic parameters except GFR before and during, usage of cefepime did not show any statistical difference between the two groups. Conclusion: The present study revealed that cefepime-induced neurotoxicity was prone to develop in patients with impaired renal function before cefepime usage.

Keywords

Acknowledgement

This work was supported by the National Research Foundation of Korea grant founded by the MSIP (No. 2013R1A2A2A040-15925).