title: Cefepime-related encephalopathy in peritoneal dialysis patients.
abstract: Encephalopathy or neurotoxicity can occur with cefepime use in patients with impaired or relatively normal renal function. However, few articles have examined the relationship between cefepime's adverse effects and peritoneal dialysis. Here, we report the case of an 80-year-old woman with chronic renal failure on peritoneal dialysis that developed agitation, confusion, and dystonia after cefepime administration for 2 days. The clinical and electroencephalographic abnormalities improved after discontinuation the drug. We review the role of peritoneal dialysis in the development of cefepime-induced encephalopathy. Peritoneal dialysis is a less efficient way to eliminate cefepime than hemodialysis. Short-term hemodialysis might be considered to facilitate elimination of the drug in patients who have developed neurotoxicity.
authors.affiliation: Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, #201 Sec. 2 Shih-Pai Road, Taipei, Taiwan, ROC.
authors.forename: Chun-Jen
authors.initials: CJ
authors.lastname: Lin
authors.forename: Shih-Pin
authors.initials: SP
authors.lastname: Chen
authors.forename: Shuu-Jiun
authors.initials: SJ
authors.lastname: Wang
authors.forename: Jong-Ling
authors.initials: JL
authors.lastname: Fuh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001927:Brain Diseases / Q000139:chemically induced*; D000077723:Cefepime; D002511:Cephalosporins / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D010530:Peritoneal Dialysis / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D000077723:Cefepime