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Seizure Propensity With Imipenem

1989; American Medical Association; Volume: 149; Issue: 8 Linguagem: Inglês

10.1001/archinte.1989.00390080131029

1538-3679

Robert H.K. Eng, Anand N. Munsif, Bienvenido G. Yangco, Susan M. Smith, Herman Chmel,

Infectious Encephalopathies and Encephalitis

Five patients with seizures related to imipenem administration are described. The potential of imipenem therapy to cause seizure was further studied in a mouse model and compared with the potential for seizure with penicillin and cefotaxime therapy. Penicillin caused ataxia and seizure at a mean mouse serum level of 5800 microns/mL, cefotaxime at 3400 microns/mL, and imipenem at a much lower serum concentration of 1900 microns/mL. The potent activity of imipenem therapy against bacteria, allowing for a clinical dose of only 2 g/d, is unfortunately offset by its higher propensity to induce neurologic symptoms in humans and mice at much smaller doses than would therapy with penicillin G or the cephalosporins, such as cefotaxime.