ArticleNeurocritical care2026
Rethinking Cefepime Neurotoxicity: An Integrated PK-Neuromonitoring Approach for Neurocritical Care.
Article in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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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.
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Authors and funding
5 authors.
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Abstract
Cefepime-induced neurotoxicity (CIN) remains under-recognized despite being a largely exposure-driven and multifactorial complication in neurocritical care. Early identification is often hindered by limited clinical evaluability, delayed electroencephalography (EEG) access, and rapidly evolving renal function that compromises dosing accuracy. Although higher cefepime exposure is consistently associated with increased neurotoxicity risk, no universally accepted therapeutic range clearly separates efficacy from toxicity across critically ill populations. This Viewpoint proposes an anticipatory approach integrating pharmacokinetic principles, therapeutic drug monitoring (TDM), and simplified neuromonitoring to facilitate earlier detection and prevent progression to severe encephalopathy or nonconvulsive seizures. We outline a pragmatic framework to enhance neurological safety while preserving antimicrobial efficacy.
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