Seizure propensity with imipenem.
Five patients with seizures related to imipenem administration are described. The potential of imipenem therapy to cause seizure was further studied in a mouse model and compared with the potential for seizure with penicillin and cefotaxime therapy. Penicillin caused ataxia and seizure at a mean mouse serum level of 5800 microns/mL, cefotaxime at 3400 microns/mL, and imipenem at a much lower serum concentration of 1900 microns/mL. The potent activity of imipenem therapy against bacteria, allowing for a clinical dose of only 2 g/d, is unfortunately offset by its higher propensity to induce neurologic symptoms in humans and mice at much smaller doses than would therapy with penicillin G or the cephalosporins, such as cefotaxime.
Eng
R H
RH
Medical Service, Veterans Administration Medical Center, East Orange, NJ 07019.
Munsif
A N
AN
Yangco
B G
BG
Smith
S M
SM
Chmel
H
H
D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002439:Cefotaxime / Q000008:administration & dosage / Q000009:adverse effects* / Q000633:toxicity; D005260:Female; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage / Q000009:adverse effects* / Q000633:toxicity; D008297:Male; D051379:Mice; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010400:Penicillin G / Q000008:administration & dosage / Q000009:adverse effects* / Q000633:toxicity; D012640:Seizures / Q000139:chemically induced*
D015378:Imipenem; D002439:Cefotaxime; D010400:Penicillin G