• Five patients with seizures related to imipenem administration are described. The potential of imipenem therapy to cause seizure was further studied in a mouse model and compared with the potential for seizure with penicillin and cefotaxime therapy. Penicillin caused ataxia and seizure at a mean mouse serum level of 5800 μm/mL, cefotaxime at 3400 μm/mL, and imipenem at a much lower serum concentration of 1900 μm/mL. The potent activity of imipenem therapy against bacteria, allowing for a clinical dose of only 2 g/d, is unfortunately offset by its higher propensity to induce neurologic symptoms in humans and mice at much smaller doses than would therapy with penicillin G or the cephalosporins, such as cefotaxime.
(Arch Intern Med. 1989;149:1881-1883)
Eng RHK, Munsif AN, Yangco BG, Smith SM, Chmel H. Seizure Propensity With Imipenem. Arch Intern Med. 1989;149(8):1881–1883. doi:10.1001/archinte.1989.00390080131029
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