title: Carnitine-associated encephalopathy caused by long-term treatment with an antibiotic containing pivalic acid.
abstract: An 18-month-old boy was treated with an antibiotic containing pivalic acid for 6 months for intractable otitis media and then developed repeated convulsions and loss of consciousness. Laboratory data showed hypoglycemia and hypocarnitinemia. Intravenous administration of glucose was ineffective against the seizures and loss of consciousness. However, the patient regained consciousness and recovered soon after intravenous infusion of carnitine. To our knowledge, intravenous carnitine administration that contributed to marked improvements in neurologic deficit caused by administration of an antibiotic containing pivalic acid has not been reported previously. These findings indicate that long-term use of such antibiotics should be avoided.
authors.affiliation: Department of Pediatrics, Toyohashi Municipal Hospital, 50 Hachiken-nishi, Aotake, Toyohashi, Aichi 441-8570, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Makino
authors.forename: Tokio
authors.initials: T
authors.lastname: Sugiura
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ito
authors.forename: Naruji
authors.initials: N
authors.lastname: Sugiyama
authors.forename: Norihisa
authors.initials: N
authors.lastname: Koyama
mesh_terms: D000138:Acidosis / Q000139:chemically induced / Q000188:drug therapy; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000737:chemistry; D001928:Brain Diseases, Metabolic / Q000139:chemically induced* / Q000188:drug therapy; D002331:Carnitine / Q000097:blood / Q000172:deficiency* / Q000627:therapeutic use; D002511:Cephalosporins / Q000009:adverse effects* / Q000737:chemistry; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D010033:Otitis Media / Q000188:drug therapy; D010421:Pentanoic Acids / Q000009:adverse effects* / Q000032:analysis; D012640:Seizures / Q000139:chemically induced; D014474:Unconsciousness / Q000139:chemically induced; D014803:Vitamin B Complex / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D010421:Pentanoic Acids; D014803:Vitamin B Complex; C057710:cefditoren pivoxil; C005566:pivalic acid; D002331:Carnitine