title: Antibiotic-induced neurotoxicity in dialysis patients: a retrospective study.
abstract: OBJECTIVE
  The study was to evaluate neurotoxicity caused by antibiotics in dialysis patients, including incidence, clinical features, treatments and prognosis.
  
  
  METHODS
  In this retrospective study, we reviewed the medical records of 1066 dialysis patients (254 peritoneal dialysis [PD] cases and 812 hemodialysis [HD] cases) who also received intravenous antibiotics in our hospital during July 2006 - April 2012. Naranjo scale was used for estimating the probability of an adverse drug reaction.
  
  
  RESULTS
  The incidence of antibiotic-induced neurotoxicity was 5.66% in patients receiving HD, and 7.87% in patients receiving PD. There was no significant difference between the two dialysis modalities about the incidence of antibiotic-induced neurotoxicity (p > 0.05). The risk factors included extremely old age, history of central nervous system disorder, low residual renal function, hypoalbuminemia, and the use of multiple antibiotics that share one mechanism. The neurotoxic antibiotics included cephalosporins, penicillins, carbapenems and quinolones in our study. Most patients could be properly diagnosed early according to their medical history, symptoms, signs, electroencephalography (EEG), other related auxiliary examination, and with the help of experienced neurologists. Most neurotoxic patients showed clinical improvement after the discontinuation of antibiotics and active treatment.
  
  
  CONCLUSIONS
  The adverse neurotoxic effects of antibiotics were common in dialysis patients due to wide and incorrect usage. Neurotoxicity could be prevented in high-risk cases with dosage adjustments. Better prognosis can be achieved with early and proper diagnosis, decisive withdrawal, and aggressive treatment including enhanced HD.
authors.affiliation: Division of Nephrology, Ningbo Urology and Nephrology Hospital, Ningbo University School of Medicine, Ningbo, Zhejiang, PR China.
authors.forename: JiSheng
authors.initials: J
authors.lastname: Zhang
authors.forename: CongYang
authors.initials: C
authors.lastname: Huang
authors.forename: Hong
authors.initials: H
authors.lastname: Li
authors.forename: Qiang
authors.initials: Q
authors.lastname: Yao
authors.forename: Jun
authors.initials: J
authors.lastname: Xu
authors.forename: JiangZi
authors.initials: J
authors.lastname: Yuan
authors.forename: JiaQi
authors.initials: J
authors.lastname: Qian
authors.forename: BeiYan
authors.initials: B
authors.lastname: Bao
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002681:China / Q000453:epidemiology; D004569:Electroencephalography; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000175:diagnosis / Q000209:etiology*; D015995:Prevalence; D011379:Prognosis; D006435:Renal Dialysis; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents