Seizures as adverse events of antibiotic drugs A systematic review

被引:172
作者
Sutter, Raoul [1 ,2 ]
Ruegg, Stephan [2 ]
Tschudin-Sutter, Sarah [3 ,4 ]
机构
[1] Univ Basel Hosp, Clin Intens Care Med, Basel, Switzerland
[2] Univ Basel Hosp, Dept Neurol, Div Clin Neurophysiol, Basel, Switzerland
[3] Univ Basel Hosp, Div Infect Dis, Basel, Switzerland
[4] Univ Basel Hosp, Hosp Epidemiol, Basel, Switzerland
关键词
NONCONVULSIVE STATUS EPILEPTICUS; VALPROIC ACID LEVELS; INTENSIVE-CARE-UNIT; GABA(A) RECEPTOR; INTRAVENOUS-INFUSION; IMIPENEM-CILASTATIN; METABOLIC-ACIDOSIS; MEROPENEM; DORIPENEM; PATIENT;
D O I
10.1212/WNL.0000000000002023
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective:Antibiotic drugs are commonly associated with seizures. Tailoring antibiotics to the individual risk for seizures is challenged as avoidance of certain antibiotic classes may no longer be possible due to the emergence of resistant bacteria. We performed a systematic review regarding the current evidence for seizures associated with all antibiotic classes, their underlying mechanisms, and predisposing factors.Methods:The medical search engine PubMed was systematically screened to identify articles in English published between 1960 and 2013. All study designs were considered and evidence was assessed.Results:We included 143 articles involving 25,712 patients and 25 different antibiotics. Evidence for antibiotic-related symptomatic seizures is low to very low, mainly deriving from studies regarding -lactams, especially unsubstituted penicillins and fourth-generation cephalosporins, as well as carbapenems, mainly imipenem, all administered in high doses or in patients with renal dysfunction, brain lesions, or known epilepsy. Evidence regarding symptomatic seizures from fluoroquinolones only relies on case reports and case series with most reports for ciprofloxacin in patients with renal dysfunction, mental disorders, prior seizures, or coadministered theophylline.Conclusions:Evidence for an association between antibiotic drugs and symptomatic seizures is low to very low (evidence Class III-IV). Despite this, numerous reports point to an increased risk for symptomatic seizures especially of unsubstituted penicillins, fourth-generation cephalosporins, imipenem, and ciprofloxacin in combination with renal dysfunction, brain lesions, and epilepsy. During administration of such antibiotics in patients with particular predispositions, close monitoring of serum levels is advocated. As most seizures associated with cephalosporins are nonconvulsive, continuous EEG should be considered in patients with altered levels of consciousness.
引用
收藏
页码:1332 / 1341
页数:10
相关论文
共 66 条
[1]  
American Academy of Neurology, 2011, CLIN PRACTICE GUIDEL
[2]  
[Anonymous], 1972, LANCET, V2, P677
[3]  
[Anonymous], 1993, EPILEPSIA, V34, P592
[4]   Cefixime-induced nonconvulsive status epilepticus [J].
Anzellotti, F. ;
Ricciardi, L. ;
Monaco, D. ;
Ciccocioppo, F. ;
Borrelli, I. ;
Zhuzhuni, H. ;
Onofrj, M. .
NEUROLOGICAL SCIENCES, 2012, 33 (02) :325-329
[5]   REVERSIBLE SEIZURES AND MENTAL STATUS CHANGES IN A DIALYSIS PATIENT ON ISONIAZID PREVENTIVE THERAPY [J].
ASNIS, DS ;
BHAT, JG ;
MELCHERT, AF .
ANNALS OF PHARMACOTHERAPY, 1993, 27 (04) :444-446
[6]   The area under the plasma concentration-time curve for oral midazolam is 400-fold larger during treatment with itraconazole than with rifampicin [J].
Backman, JT ;
Kivistö, KT ;
Olkkola, KT ;
Neuvonen, PJ .
EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY, 1998, 54 (01) :53-58
[7]   SEIZURES ASSOCIATED WITH HIGH CEREBROSPINAL-FLUID CONCENTRATIONS OF CEFAZOLIN [J].
BECHTEL, TP ;
SLAUGHTER, RL ;
MOORE, TD .
AMERICAN JOURNAL OF HOSPITAL PHARMACY, 1980, 37 (02) :271-273
[8]   Levofloxacin-related seizure activity in a patient with Alzheimer's disease: Assessment of potential risk factors [J].
Bird, SB ;
Orr, PG ;
Mazzola, JL ;
Brush, DE ;
Boyer, EW .
JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY, 2005, 25 (03) :287-288
[9]   FACTORS PREDISPOSING TO SEIZURES IN SERIOUSLY ILL INFECTED PATIENTS RECEIVING ANTIBIOTICS - EXPERIENCE WITH IMIPENEM-CILASTATIN [J].
CALANDRA, G ;
LYDICK, E ;
CARRIGAN, J ;
WEISS, L ;
GUESS, H .
AMERICAN JOURNAL OF MEDICINE, 1988, 84 (05) :911-918
[10]   CARBAMAZEPINE TOXICITY INDUCED BY CONCURRENT ERYTHROMYCIN THERAPY [J].
CARRANCO, E ;
KAREUS, J ;
CO, S .
ARCHIVES OF NEUROLOGY, 1985, 42 (02) :187-188