Cefepime Related Neurological Complications in a Dialysis Patient: A Case Report

Cefepime, a parenteral fourth-generation cephalosporin, is used to treat multi-resistant and severe infections.However, it can induce neurotoxicity, especially in patients with renal impairment.In this case, the 30-year-old male patient, undergoing hemodialysis for chronic renal failure, presented with dysuria.Cefepime treatment was initiated following the identification of Staphylococcus aureus growth in both catheter and peripheral blood cultures.On the third day of treatment, the patient exhibited altered consciousness, impaired coordination, and dysarthric speech.Drug intoxication due to cefepime was suspected, leading to its discontinuation and early hemodialysis.The patient was then switched to piperacillin-tazobactam, and all negative neurological symptoms improved on the second day.Adjusting the maintenance dose based on renal function is important, although neurotoxicity may still occur.Clinicians should closely monitor patients with reduced renal function for changes in mental status.If cefepime toxicity is suspected, discontinuing the drug and considering dialysis may improve the patient's clinical symptoms.