Ceftriaxone-induced Neurotoxicity in a Patient after Pancreas-Kidney Transplantation

Intern Med. 2017 Nov 15;56(22):3103-3107. doi: 10.2169/internalmedicine.8774-16. Epub 2017 Sep 25.


Ceftriaxone is a widely used third-generation cephalosporin showing advantageous pharmacokinetic properties and a broad antimicrobial spectrum. We herein report a case of ceftriaxone-induced neurotoxicity in a 56-year-old man on hemodialysis. Seven days after initiating high-dose ceftriaxone, the patient developed impaired consciousness along with facial myoclonus and sporadic phonation. The symptoms clearly disappeared shortly after withdrawal of the drug. Ceftriaxone is considered a safe antibiotic for patients with renal insufficiency, since it is excreted via both haptic and renal pathways. Physicians should note that antibiotic-associated encephalopathy may develop in patients administered ceftriaxone, especially in those complicated with renal dysfunction.

Keywords: antibiotic-associated encephalopathy; ceftriaxone; chronic kidney disease; hemodialysis; nonconvulsive status epilepticus; transplantation.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / therapeutic use
  • Brain Diseases / chemically induced*
  • Ceftriaxone / adverse effects*
  • Ceftriaxone / therapeutic use
  • Humans
  • Kidney Transplantation / methods*
  • Male
  • Middle Aged
  • Pancreas Transplantation / methods*
  • Renal Dialysis / methods


  • Anti-Bacterial Agents
  • Ceftriaxone