Cefazolin induced seizures in hemodialysis patients.
Cephalosporins are epileptogenic drugs, especially when excessive dosages are used or when the drugs are used in patients with decreased renal clearance. The present case report showed that a chronic kidney patient receiving hemodialysis developed generalized tonic clonic seizures when an inappropriate high dose cefazolin was given. Cefazolin 2 g iv q 8 h was given for 25 days continuously to treat fever of unknown origin in a patient who was a severe renal impairment patient. In a severe renal impairment patient, the maintenance dose of cefazolin should be reduced by half and the interval for administration should be extended to 24 h. Even though hemodialysis could remove cefazolin from the blood circulation, in the presented case the very high dose of cefazolin given was far beyond the ability of hemodialysis to clear the drug. The accumulation ofcefazolin, therefore, induced three episodes of seizures on days 14, 21 and 25. More precaution should be taken when prescribing medication to a patient with predisposing factors.
Arkaravichien
Wiwat
W
Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand. wiwat@kku.ac.th
Tamungklang
Janyarat
J
Arkaravichien
Tarinee
T
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002437:Cefazolin / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic; D006435:Renal Dialysis; D012306:Risk; D012640:Seizures / Q000139:chemically induced*
D000900:Anti-Bacterial Agents; D002437:Cefazolin