{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:56:46Z","timestamp":1792612606080,"version":"4.5.0"},"reference-count":13,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>\n                    <jats:bold>Introduction and Objective:<\/jats:bold>\n                    Cefazolin-induced encephalopathy and seizures are possibly related to excessive dosing; especially in those with renal dysfunction. This report aims to highlight the importance of dose adjustments of cefazolin in patients with diminished renal function.\n                    <jats:bold>Case Presentation:<\/jats:bold>\n                    An 87-year-old female with a history of cognitive impairment, remote cerebellar infarcts, hypertension, and hypothyroidism presented with acute delirium associated with a urinary tract infection. Her condition worsened and she was found to have a methicillin-sensitive\n                    <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                    bacteremia for which she was started on cefazolin 2\u00a0grams intravenously every 4 hours. Based on her renal function, recommended dosing would have been 2\u00a0grams intravenously every 12 hours. After 3 days on this regimen her mentation declined and she suffered a tonic-clonic seizure. She did not regain consciousness and was transitioned to comfort care prior to her death.\n                    <jats:bold>Discussion:<\/jats:bold>\n                    Supratherapeutic dosing of cefazolin may have led to significant neurotoxic effects. Neurotoxicity and seizures can occur with drug accumulation from an increase in excitatory neurotransmitters along with a decrease in inhibitory neurotransmitter activity. The effect is potentiated by older age, pre-existing central nervous system conditions, and renal failure. Therapeutic drug monitoring is a potential strategy to limit the risk of drug toxicity.\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    This case outlines a poor outcome in the context of high-dose cefazolin. It serves as a reminder to clinicians for ongoing pharmacovigilance in adhering to treatment guidelines.\n                  <\/jats:p>","DOI":"10.1177\/08971900251326735","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T18:06:46Z","timestamp":1741802806000},"page":"529-533","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Seizures Associated With High-Dose Cefazolin in a Patient With Renal Dysfunction: A Case Report"],"prefix":"10.1177","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9990-8081","authenticated-orcid":false,"given":"Kulwant","family":"Kingra","sequence":"first","affiliation":[{"name":"University of Manitoba"},{"name":"University of Manitoba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert E.","family":"Ariano","sequence":"additional","affiliation":[{"name":"St. Boniface Hospital Pharmacy"},{"name":"University of Manitoba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Sharma","sequence":"additional","affiliation":[{"name":"University of Manitoba"},{"name":"University of Manitoba"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"e_1_3_4_2_2","volume-title":"Staphylococcus Aureus","author":"Taylor TA","year":"2022","unstructured":"Taylor TA, Unakal CG. 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