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August 1989

Seizure Propensity With Imipenem

Author Affiliations

From the Infectious Disease Section, Medical Service (Drs Eng and Munsif) and Microbiology Section, Laboratory Service (Dr Smith), Veterans Administration Medical Center, East Orange, NJ; Departments of Medicine (Drs Eng and Munsif) and Pathology and Microbiology (Dr Smith), University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark; and Division of Infectious and Tropical Diseases, Department of Internal Medicine, University of South Florida College of Medicine, Tampa (Drs Yangco and Chmel).

Arch Intern Med. 1989;149(8):1881-1883. doi:10.1001/archinte.1989.00390080131029

• 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)

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