Treatment of cefuroxime-induced neurotoxicity with continuous venovenous haemofiltration.

A 61-year-old woman with decreased consciousness, myoclonus, tremors, nystagmus and bradypnoea, due to cefuroxime-induced neurotoxicity, was admitted to the intensive care unit. Continuous venovenous haemofiltration (CVVH) rapidly reduced plasma cefuroxime concentrations and improved neurological manifestations within the next few hours. Retrospective pharmacokinetic assessment showed a total cefuroxime clearance of 166 ml/min during the CVVH.

[1]  N. Foudraine,et al.  Population Pharmacokinetics of Cefuroxime in Critically Ill Patients Receiving Continuous Venovenous Hemofiltration With Regional Citrate Anticoagulation and a Phosphate-Containing Replacement Fluid , 2016, Therapeutic drug monitoring.

[2]  A. Verstraete,et al.  Population pharmacokinetics and dosing simulations of cefuroxime in critically ill patients: non-standard dosing approaches are required to achieve therapeutic exposures. , 2014, The Journal of antimicrobial chemotherapy.

[3]  R. Maganti,et al.  Cephalosporin-Induced Neurotoxicity: Clinical Manifestations, Potential Pathogenic Mechanisms, and the Role of Electroencephalographic Monitoring , 2008, The Annals of pharmacotherapy.

[4]  C. Bouman Antimicrobial dosing strategies in critically ill patients with acute kidney injury and high-dose continuous veno-venous hemofiltration , 2008, Current opinion in critical care.

[5]  C. Ronco,et al.  Practice patterns in the management of acute renal failure in the critically ill patient: an international survey. , 2006, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[6]  P. Derambure,et al.  Cefepime-induced neurotoxicity: an underestimated complication of antibiotherapy in patients with acute renal failure , 2002, Intensive Care Medicine.

[7]  G. Hodges,et al.  Neurotoxicity of antibacterial agents , 1984, Annals of internal medicine.

[8]  J. Lefrock,et al.  Cefuroxime: antimicrobial activity, Pharmacology, and clinical efficacy. , 1983, Therapeutic drug monitoring.

[9]  P. Gower,et al.  The pharmacokinetics of cefuroxime after intravenous injection , 1977, European Journal of Clinical Pharmacology.

[10]  R. Foord Cefuroxime: Human Pharmacokinetics , 1976, Antimicrobial Agents and Chemotherapy.