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Case Reports
. 2020 Oct;42(5):655-657.
doi: 10.1097/FTD.0000000000000786.

Neurotoxicity Despite a Renal Function-Adjusted Cefepime Regimen: A Case Study

Xavier Engalenc  1 , Caroline Monchaud  2 , Naïma Tafzi  2 , Jean-Baptiste Woillard  2
Affiliations
Case Reports

Neurotoxicity Despite a Renal Function-Adjusted Cefepime Regimen: A Case Study

Xavier Engalenc et al. Ther Drug Monit. 2020 Oct.

Abstract

An 83-year-old man, presenting decreased renal function (estimated glomerular filtration rate 21 mL/min/1.73 m), was treated for a bone and joint infection (on a trans-metatarsal right foot amputation) caused by Klebsiella Pneumonia sensitive to cefepime. The starting dose (1 g bid) was based on recommendations for patients presenting severe infections. One week after treatment initiation, the patient developed neurotoxicity, exhibiting extremely high plasma cefepime concentrations. Based on TDM, the dose was reduced by 8 times the original dose. This case report highlights the importance of therapeutic drug monitoring for cefepime, especially in patients presenting altered renal functions, as typical recommendations are estimated for standard patients.

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