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Michal A. Douglas, MD; Christine M. Quandt, PharmD; Deborah A. Stanley, PharmD
College of Pharmacy Clinical Division University of Texas at Austin Austin, TX 78712

Arch Neurol. 1988;45(9):936-937.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Large doses of parenterally administered penicillin G may produce confusion, lethargy, twitching, multifocal myoclonus, and localized or generalized epileptiform seizures, particularly in patients with renal impairment.^1-3 Cephalosporins, with chemical structures similar to the penicillins, have likewise been reported to cause encephalopathies³ with lethargy, disorientation, memory loss, asterixis, multifocal myoclonus, and tonic-clonic seizures (cefazolin⁴ and cephaloridine⁵). This report was prompted by the occurrence of encephalopathy in a patient with renal impairment on administration of intravenous ceftazidime, one of the newer third-generation cephalosporins.

Report of a Case.

—An 80-year-old man at our institution was treated for osteomyelitis with intravenous ceftazidime therapy following hip replacement surgery. Therapy was begun with a dosage regimen of intravenous ceftazidime 2 g every eight hours. The patient's serum creatinine level was 265.2 µmol/L (3.0 mg/dL) and his measured creatinine clearance was 0.58 mL/s (35 mL/min). His baseline mental status was . . . [Full Text PDF of this Article]

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