ArticleBMC nephrology2022
Ertapenem-induced neurotoxicity in an end-stage renal disease patient on intermittent haemodialysis: a case report.
Article in BMC nephrology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 8 citations in OpenAlex.
- Ertapenem-Associated Neurotoxicity in a Patient With Chronic Kidney Disease and Hypothyroidism: A Case Report.Cureus · 2026Article
- Prevalence and antibiotic resistance of pathogens isolated from neurosurgical patients with postoperative central nervous system infections in a tertiary hospital in North China.Frontiers in public health · 2025Article
- Ertapenem-induced encephalopathy in a patient with liver abscess and acute kidney injury.BMJ case reports · 2024Article
- Antibiotic-induced neuropsychiatric toxicity: epidemiology, mechanisms and management strategies - a narrative literature review.Drugs in context · 2024Review
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3 authors at 1 institution in 1 country.
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Abstract
backgroundCarbapenem-induced neurotoxicity is an unusual side effect, with seizure being the most commonly reported symptom. Among the carbapenems, imipenem-cilastin is classically associated with the most severe neurotoxicity side effects. Carbapenem is mainly excreted by the kidney and its half-life is significantly increased in patients with chronic kidney disease (CKD). Therefore, dose adjustment is necessary in such patients. Ertapenem-associated neurotoxicity is increasingly being reported in CKD patients, but rarely seen in patients with recommended dose adjustment. CASE PRESENTATION: We report a case of a 56-year-old male patient with chronic kidney disease 5 on dialysis(CKD 5D). The patient presented with a history of fever, chills and rigours during a session of haemodialysis (HD). He was diagnosed with Enterobacter cloacae catheter-related blood stream infection and was started on ertapenem. After 13 days of ertapenem, he experienced an acute confusional state and progressed to having auditory and visual hallucinations. His blood investigations and imaging results revealed no other alternative diagnosis. Hence a diagnosis of ertapenem-induced neurotoxicity was made. He had complete resolution of symptoms after 10 days' discontinuation of ertapenem.
conclusionOur case draws attention to the risk of potentially serious toxicity of the central nervous system in HD patients who receive the current recommended dose of ertapenem. It also highlights that renal dosing in CKD 5D patients' needs to be clinically studied to ensure antibiotic safety.
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