Evidence map›Paper›PMID 41793739›Full record

ArticleThe Journal of antimicrobial chemotherapy2026

Identification and assessment of paediatric cefepime-induced neurotoxicity in a retrospective cohort of paediatric intensive care patients.

Kathryn Pavia, Melissa E Day, H Rhodes Hambrick, Anna Sibilia, Matthew Fenchel, Kelli Paice, Jennifer Kaplan, Sonya Tang Girdwood

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of antimicrobial chemotherapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kathryn PaviaDivision of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.ORCID 0000-0002-6231-3323
Melissa E DayDivision of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
H Rhodes HambrickDivision of Translational and Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Anna SibiliaDivision of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Matthew FenchelDivision of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Kelli PaiceDivision of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Jennifer KaplanDivision of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Sonya Tang GirdwoodDivision of Translational and Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.ORCID 0000-0001-7737-8499

Funding

T32 Cincinnati Pediatric Clinical Pharmacology Training ProgramT32HD069054 · NICHD · CINCINNATI CHILDRENS HOSP MED CTR · PI TRACY A GLAUSER, Sonya C Tang Girdwood · 2011 to 2026
$3.0M
Antibiotic Model-Informed Precision Dosing in Critical IllnessR35GM146701 · NIGMS · CINCINNATI CHILDRENS HOSP MED CTR · PI Sonya C Tang Girdwood · 2022 to 2026
$2.0M
NICHD NIH HHS T32 HD069054NIGMS NIH HHS R35 GM146701NIH HHS R35GM146701NIH T32 Pediatric Clinical and Developmental Pharmacology Training Program T32HD069054
6 · The paper itself

Abstract

BACKGROUND AND

objectiveCefepime-induced neurotoxicity (CIN) is a recognized side effect of excessive cefepime exposure and high plasma concentrations in adults. However, the relationship between cefepime concentrations and neurotoxic symptoms in paediatric patients is unknown. The objective of this paper is to explore the relationship between cefepime pharmacokinetics and CIN in a paediatric intensive care unit (PICU) cohort. PATIENTS AND

methodsPICU patients with cefepime concentrations measured for a previous PK study were chosen for this cohort. CIN symptoms and related testing were evaluated by retrospective chart review and likelihood of causal association was determined using blinded adjudicators via the Naranjo adverse drug reaction probability scale.

resultsAmong 73 patients with complete data, 43 patients (59%) had either no neurotoxicity or neurotoxicity doubtful to be CIN, while 25 (34%) patients had possible CIN and five (7%) had probable CIN. Symptoms of neurotoxicity included irritability, altered mental status, depressed level of consciousness, myoclonus, seizures and delirium. There were no differences in age, sex, severity of illness or renal dysfunction among groups. Patients with probable CIN had higher cefepime area under the curve (2250 versus 1107 mg*h/L, P = 0.03) and peak concentrations (232 versus 172 mg/L, P < 0.001).

conclusionsThis investigation presents a paediatric cohort analysis of CIN and provides preliminary evidence supporting the hypothesis that neurotoxicity risk is probably concentration dependent in this age group and presents with similar spectrum of symptoms as those described in adults.

Indexed as

Anti-Bacterial AgentsCephalosporinsNeurotoxicity SyndromesAdolescentCefepimeChildChild, PreschoolCohort StudiesFemaleHumansInfantIntensive Care Units, PediatricMaleRetrospective StudiesThird Generation CephalosporinsAnti-Bacterial AgentsCefepimeCephalosporinsThird Generation Cephalosporins

Identifiers

PMID41793739
PMCPMC13016889

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.