Cefepime-induced encephalopathy in an older patient with polypharmacy and renal insufficiency: a case report

J Int Med Res. 2024 May;52(5):3000605241244743. doi: 10.1177/03000605241244743.

Abstract

The world population is rapidly aging. Societal aging poses many challenges for individuals, families, nations, and the global healthcare system. Therefore, geriatric care is a crucial issue that demands our attention. In this case report, we describe a woman in her early 70s with multiple comorbidities, polypharmacy, and renal insufficiency who developed cefepime-induced encephalopathy with moderate to severe cerebral dysfunction during treatment of a urinary tract infection. The patient's consciousness level gradually improved, and no further seizures were observed following the discontinuation of cefepime for several days. This case report underscores the fact that polypharmacy and medication safety are significant concerns that are often overlooked when caring for older patients. The report also highlights the increased susceptibility of older individuals to antibiotic-associated adverse reactions during the management of infectious diseases. Therefore, optimization of antibiotic therapy for older patients is a critical issue that requires thorough investigation and consideration in geriatric care.

Keywords: Cefepime; adverse reaction; case report; encephalopathy; polypharmacy; renal insufficiency.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents* / adverse effects
  • Anti-Bacterial Agents* / therapeutic use
  • Brain Diseases* / chemically induced
  • Cefepime* / adverse effects
  • Cefepime* / therapeutic use
  • Female
  • Humans
  • Polypharmacy*
  • Renal Insufficiency* / chemically induced
  • Urinary Tract Infections* / drug therapy

Substances

  • Cefepime
  • Anti-Bacterial Agents