Cefepime related status epilepticus

Abstract

Cefepime is a fourth-generation cephalosporin β-lactam antibiotic. Neurotoxic eff ects of cefepime include slurred speech, tremor, encephalopathy and seizures. Presented herein are two cases of a 7-year-old boy and 16-year-old girl who developed cefepime-related neurotoxicity. The fi rst patient who had uncontrolled epilepsy was stable for 1 month while on ketogenic diet, when he developed convulsive status epilepticus following two doses of cefepime initiated for cellulitis. The second patient that had undergone an arteriovenous fi stula after being placed on a hemodialysis program for chronic renal failure was administered cefepime for an infection at the site of the fi stula. On the third day of antibiotic treatment, she developed non-convulsive status epilepticus. The second patient was a typical case of cefepime-related neurotoxicity due to renal failure. To the best of our knowledge, convulsive status epilepticus has not been reported before in association with cefepime treatment, which underlines the signifi cance of our fi rst cases.