AI Article Synopsis

  • Ten cases of neurotoxicity related to ertapenem treatment were reported, with symptoms primarily involving confusion and some leading to death.
  • Most patients (90%) had impaired kidney function (creatinine clearance < 50 mL/min) and low albumin levels before starting the medication.
  • Adjusting the dosage based on renal function and monitoring for symptoms like confusion is crucial, as early detection can significantly improve patient outcomes.

Article Abstract

Ten cases of ertapenem neurotoxicity, mainly confusional states, are described, some of them with fatal outcomes. The majority of patients (90%) had a creatinine clearance (CrCl) < 50 mL/min/1.73m at some point during treatment and hypoalbuminaemia was always present when ertapenem treatment was started. The pharmacokinetic and pharmacodynamic properties of this carbapenem could favour a different profile, and approved doses can be excessive in some patients with moderate renal failure (CrCl 31-59 mL/min/1.73 m ). It may be necessary to re-evaluate renal function during treatment and adjust doses or reconsider the adequacy of treatment based on clinical judgement, especially if relevant changes in the CrCl occur (i.e. a reduction to ≤30 mL/min/1.73 m ) or unexplained behavioural disorders are detected. The onset of the symptoms of ertapenem neurotoxicity can be insidious and go unnoticed, and so a knowledge and early suspicion of confusional states are important to improve the patient prognosis.

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Source
http://dx.doi.org/10.1111/bcp.14582DOI Listing

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