{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T03:01:40Z","timestamp":1789095700685,"version":"build-2803163510"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2017,10,10]],"date-time":"2017-10-10T00:00:00Z","timestamp":1507593600000},"content-version":"vor","delay-in-days":282,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Neurotoxicity due to cefepime has not been well characterized. We performed a systematic review of the literature and included 5 additional cases from our center. Of the 198 cases found, the mean age was 67 years and 87% of patients had renal dysfunction. The most common clinical features were diminished level of consciousness (80%), disorientation\/agitation (47%), and myoclonus (40%). It is worth noting that nonconvulsive status epilepticus was relatively common with 31% of cases, whereas only 11% had convulsive seizures. Single-center estimate of incidence was 1 in 480 courses of cefepime. Cefepime neurotoxicity should be considered in older patients with renal dysfunction and new onset encephalopathy, especially if concurrent myoclonus is present. More work is needed to prospectively assess incidence and outcomes related to cefepime neurotoxicity.<\/jats:p>","DOI":"10.1093\/ofid\/ofx170","type":"journal-article","created":{"date-parts":[[2017,10,10]],"date-time":"2017-10-10T11:06:33Z","timestamp":1507633593000},"source":"Crossref","is-referenced-by-count":104,"title":["Characterizing Cefepime Neurotoxicity: A Systematic Review"],"prefix":"10.1093","volume":"4","author":[{"given":"Ayesha A","family":"Appa","sequence":"first","affiliation":[{"name":"Division of Allergy and Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupali","family":"Jain","sequence":"additional","affiliation":[{"name":"Division of Allergy and Infectious Diseases"},{"name":"School of Pharmacy, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M","family":"Rakita","sequence":"additional","affiliation":[{"name":"Division of Allergy and Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahin","family":"Hakimian","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul S","family":"Pottinger","sequence":"additional","affiliation":[{"name":"Division of Allergy and Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,10,10]]},"reference":[{"key":"2020081005181239100_CIT0001","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/j.idc.2009.06.007","article-title":"Newer beta-lactam antibiotics: doripenem, ceftobiprole, ceftaroline, and cefepime","volume":"23","author":"Bazan","year":"2009","journal-title":"Infect Dis Clin North Am"},{"key":"2020081005181239100_CIT0002","doi-asserted-by":"crossref","first-page":"68S","DOI":"10.1016\/S0002-9343(96)00110-6","article-title":"Safety of cefepime: a new extended-spectrum parenteral cephalosporin","volume":"100","author":"Neu","year":"1996","journal-title":"Am J Med"},{"key":"2020081005181239100_CIT0003","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1093\/jac\/dki448","article-title":"Empirical antibiotic monotherapy for febrile neutropenia: systematic review and meta-analysis of randomized controlled trials","volume":"57","author":"Paul","year":"2006","journal-title":"J Antimicrob Chemother"},{"key":"2020081005181239100_CIT0004","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/S1473-3099(07)70109-3","article-title":"Efficacy and safety of cefepime: a systematic review and meta-analysis","volume":"7","author":"Yahav","year":"2007","journal-title":"Lancet Infect Dis"},{"key":"2020081005181239100_CIT0005","author":"US Food and Drug Administration"},{"key":"2020081005181239100_CIT0006","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1093\/jac\/dkr138","article-title":"Is cefepime safe for clinical use? 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