Ceftriaxone-induced Encephalopathy: A Pharmacokinetic Approach.

[en] We report a case of ceftriaxone-induced encephalopathy correlated with a high concentration of the drug in cerebrospinal fluid (CSF). Cephalosporin neurotoxicity is increasingly reported, especially in association with fourth-generation cephalosporins. The factors influencing CSF concentration are plasma concentration, liposolubility, ionization, molecular weight, protein binding and efflux. In our patient, high levels of ceftriaxone (27.9 mg/l) were found in CSF. β-Lactam-associated neurotoxicity is mainly due to similarities between GABA and the β-lactam ring. Because of differences in CSF/plasma ratios and blood-brain barrier efflux among patients, plasma drug monitoring cannot be used to estimate CSF concentration. As far as we know, this is the first reported case of ceftriaxone-induced encephalopathy associated with a high CSF concentration. LEARNING POINTS: Ceftriaxone dose adjustment and clinical surveillance are strongly recommended in patients with renal failure.Measuring ceftriaxone cerebrospinal fluid concentration could be useful for confirming ceftriaxone-induced encephalopathy.

Disciplines :

Anesthesia & intensive care

Author, co-author :

Jadot, Laurent

Judong, Aurelie

CANIVET, Jean-Luc ; Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service des soins intensifs

Lorenzo-Villalba, Noel

Damas, Pierre

Language :

English

Title :

Ceftriaxone-induced Encephalopathy: A Pharmacokinetic Approach.

Publication date :

2021

Journal title :

European Journal of Case Reports in Internal Medicine

eISSN :

2284-2594

Publisher :

SMC MEDIA, Milano, Italy

Volume :

Issue :

Pages :

003011

Commentary :

Available on ORBi :

since 18 February 2022

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