Ceftiaxone-induced neurotoxicity: case report, pharmacokinetic considerations, and literature review

J Korean Med Sci. 2012 Sep;27(9):1120-3. doi: 10.3346/jkms.2012.27.9.1120. Epub 2012 Aug 22.


Ceftriaxone is widely used in patients for the treatment of serious gram-negative infections. Ceftriaxone can induce some potential side effects, including neurotoxicity, however, nonconvulsive status epilepticus has rarely been reported. We report a case of acute reversible neurotoxicity associated with ceftriaxone. A 65-yr-old woman with chronic kidney disease developed altered consciousness during ceftriaxone treatment for urinary tract infection. The electroencephalogram demonstrated continuous bursts of generalized, high-voltage, 1 to 2 Hz sharp wave activity. Neurologic symptoms disappeared following withdrawal of ceftriaxone. The possibility of ceftriaxone-induced neurotoxicity should be considered in patients developing neurological impairment during ceftriaxone use, and the discontinuation of the drug could lead to complete neurological improvement.

Keywords: Ceftriaxone; Cephalosporins; Chronic Kidney Failure; Seizures.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / therapeutic use
  • Anticoagulants / therapeutic use
  • Ceftriaxone / adverse effects*
  • Ceftriaxone / therapeutic use
  • Electroencephalography
  • Female
  • Humans
  • Nervous System Diseases / etiology*
  • Renal Dialysis
  • Renal Insufficiency, Chronic / pathology
  • Seizures / etiology
  • Thrombosis / diagnosis
  • Thrombosis / drug therapy
  • Tomography, X-Ray Computed
  • Urinalysis
  • Urinary Tract Infections / diagnosis
  • Urinary Tract Infections / drug therapy


  • Anti-Bacterial Agents
  • Anticoagulants
  • Ceftriaxone