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Seizure aggravation by ampicillin/sulbactam in an elderly patient with status epilepticus.
Int J Emerg Med
January 2025
Department of Neurology, Tenri Hospital, Tenri, Nara, Japan.
Background: Ampicillin/sulbactam (ABPC/ SBT) is one of the most common β-lactam antibiotics for patients with status epilepticus complicated with aspiration pneumonia. It is known that β-lactam antibiotics such as penicillin aggravate epileptic seizures or status epilepticus. Here, we investigated whether ABPC/SBT aggravates seizures using electroencephalography (EEG) monitoring.
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- - Alcohol use disorder is prevalent in the U.S., and while benzodiazepines are typically recommended for alcohol withdrawal syndrome (AWS), there’s a growing trend to use phenobarbital, especially for patients at high risk of severe AWS.
- - A quality improvement study at a medical institution evaluated the effectiveness of a phenobarbital-based treatment protocol for AWS, measuring rates of protocol adherence and clinical outcomes before and after implementation.
- - Results showed a significant increase in the administration of phenobarbital, a decrease in the combined use of benzodiazepines, and a reduction in total benzodiazepine dosage, with improved safety outcomes such as fewer days in the ICU for those transferred.
Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal in the Medical Intensive Care Unit (ICU): A Retrospective Cohort Study.
J Pharm Pract
September 2024
Department of Pharmacy, Michigan Medicine, Department of Clinical Pharmacy, College of Pharmacy, Ann Arbor, MI, USA.
Article Synopsis
- Phenobarbital (PHB) is found to be a safe and effective alternative to benzodiazepines (BZD) for treating severe alcohol withdrawal syndrome (AWS), but its safety in patients previously treated with BZD is unclear.
- A study compared critically ill patients with severe AWS receiving either PHB or BZD in the ICU to assess outcomes such as resolution of altered mentation, seizures, and length of hospital stay.
- Results showed no significant difference in the primary outcome between the two groups, but fewer seizures occurred in the PHB group, indicating that PHB may be a viable treatment option after BZD if patients are still experiencing uncontrolled withdrawal.
Safety of Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal in Critically Ill Patients With Primary Neurologic Injuries.
Ann Pharmacother
August 2024
Division of Neurocritical Care and Hospital Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Article Synopsis
- Alcohol withdrawal syndrome (AWS) is treated primarily with benzodiazepines, but recent studies suggest phenobarbital might be a safer and more effective treatment, especially in patients with neurological injuries.
- A study analyzed 84 ICU patients with neurological injuries who received either phenobarbital or benzodiazepines for AWS, measuring oversedation and other outcomes within 24 hours of treatment.
- Results showed no significant difference in oversedation or other secondary outcomes between the two treatments, although phenobarbital led to higher additional sedative use; overall, phenobarbital did not independently increase oversedation risk.
Kava Withdrawal Treated With Phenobarbital-A Case Report and Literature Review.
J Addict Med
October 2024
From the Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN.
Kava consumption is a traditional practice in Polynesian and Micronesian cultures. It has recently gained popularity in the United States for therapeutic and recreational use. We report the following case.
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