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Characterizing Ertapenem Neurotoxicity: A Systematic Review and Experience at a Tertiary Medical Center
Journal article   Peer reviewed

Characterizing Ertapenem Neurotoxicity: A Systematic Review and Experience at a Tertiary Medical Center

Hayato Mitaka, Shinya Hasegawa, Kristine F. Lan, Rupali Jain, Robert M. Rakita and Paul S. Pottinger
Open forum infectious diseases, Vol.11(5), p.ofae214
05/01/2024
DOI: 10.1093/ofid/ofae214
PMID: 38715573
url
https://doi.org/10.1093/ofid/ofae214View
Published (Version of record) Open Access

Abstract

Ertapenem-induced neurotoxicity has not been well characterized and is potentially underreported. We conducted a systematic review of the literature and included 11 additional cases from the University of Washington Medicine health system. A total of 125 individual patient cases were included in the data analysis. The mean age was 72 years, and 62% and 42% of patients had renal dysfunction and preexisting central nervous system (CNS) conditions, respectively. Only 15% of patients received inappropriately high ertapenem dosing based on kidney function. Patients developed neurological signs and symptoms after a median of 4 days (interquartile range, 3-9 days). The most common clinical features were seizures (70%), altered level of consciousness or delirium (27%), and hallucinations (17%). An estimated incidence in our health system was 1 in 102 courses of ertapenem. Ertapenem neurotoxicity should be suspected when a patient with renal dysfunction or predisposing CNS conditions develops neurological signs and symptoms, especially within several days after initiating the antibiotic. This study underscores the need for a large prospective study to assess the true incidence and outcomes of ertapenem neurotoxicity.
 Immunology Infectious Diseases Life Sciences & Biomedicine Microbiology Science & Technology

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