Ceftriaxone-induced Neurotoxicity in a Patient after Pancreas-Kidney Transplantation

Hideharu Hagiya; Koji Miyawaki; Norihisa Yamamoto; Hisao Yoshida; Akihiro Kitagawa; Tadafumi Asaoka; Hidetoshi Eguchi; Yukihiro Akeda; Kazunori Tomono

doi:10.2169/internalmedicine.8774-16

This article has now been updated. Please use the final version.

Ceftriaxone-induced Neurotoxicity in a Patient after Pancreas-Kidney Transplantation

Hideharu Hagiya, Koji Miyawaki, Norihisa Yamamoto, Hisao Yoshida, Akihiro Kitagawa, Tadafumi Asaoka, Hidetoshi Eguchi, Yukihiro Akeda, Kazunori Tomono

Author information

Hideharu Hagiya
Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, Japan
Koji Miyawaki
Department of Pharmacy, Osaka University Hospital, Japan
Norihisa Yamamoto
Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, Japan
Hisao Yoshida
Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, Japan
Akihiro Kitagawa
Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Japan
Tadafumi Asaoka
Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Japan
Hidetoshi Eguchi
Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Japan
Yukihiro Akeda
Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, Japan
Kazunori Tomono
Department of Infection Control and Prevention, Osaka University Graduate School of Medicine, Japan

Keywords: antibiotic-associated encephalopathy, ceftriaxone, chronic kidney disease, hemodialysis, nonconvulsive status epilepticus, transplantation

JOURNAL OPEN ACCESS Advance online publication

Article ID: 8774-16

DOI https://doi.org/10.2169/internalmedicine.8774-16

The final version of this article is now available: Vol. 56 (2017), No. 22 pp. 3103-3107

Details

Abstract

Ceftriaxone is a widely used third-generation cephalosporin showing advantageous pharmacokinetic properties and a broad antimicrobial spectrum. We herein report a case of ceftriaxone-induced neurotoxicity in a 56-year-old man on hemodialysis. Seven days after initiating high-dose ceftriaxone, the patient developed impaired consciousness along with facial myoclonus and sporadic phonation. The symptoms clearly disappeared shortly after withdrawal of the drug. Ceftriaxone is considered a safe antibiotic for patients with renal insufficiency, since it is excreted via both haptic and renal pathways. Physicians should note that antibiotic-associated encephalopathy may develop in patients administered ceftriaxone, especially in those complicated with renal dysfunction.

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