Case Report

Cefepime-induced neurotoxicity

Jessica Taylor, Hannah M. Gunter, Karen Cohen
Southern African Journal of Infectious Diseases | Vol 40, No 1 | a704 | DOI: https://doi.org/10.4102/sajid.v40i1.704 | © 2025 Jessica Taylor, Hannah M. Gunter, Karen Cohen | This work is licensed under CC Attribution 4.0
Submitted: 09 November 2024 | Published: 30 April 2025

About the author(s)

Jessica Taylor, Division of Clinical Pharmacology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Hannah M. Gunter, Division of Clinical Pharmacology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Karen Cohen, Division of Clinical Pharmacology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

Abstract

We present a case of severe cefepime-induced neurotoxicity following acute kidney injury in a patient with a fracture-related infection. Despite stopping cefepime, the patient required intubation, ventilation, multiple antiepileptic drugs for seizure control, and haemodialysis.

Contribution: Cefepime-induced neurotoxicity is a reversible cause of encephalopathy. Early recognition and cefepime withdrawal are crucial. As cefepime use in South Africa increases due to antimicrobial resistance, healthcare workers must be aware of this under-recognised, under-reported serious adverse drug reaction.


Keywords

cefepime; neurotoxicity; cefepime-induced neurotoxicity; adverse drug reaction; encephalopathy

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