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Data on individual carbapenems and seizure activity are scarce. To evaluate the available evidence on the association between carbapenem agents and seizure activity, we conducted a literature search of the MEDLINE (1966\u2014May 2010), EMBASE (1974\u2013May 2010), and International Pharmaceutical Abstracts (1970\u2014May 2010) databases. Reference citations from the retrieved articles were also reviewed. Mechanistically, seizure propensity of the \u03b2\u2010lactams is related to their binding to 7\u2010aminobutyric acid (GABA) receptors. There are numerous reports of seizure activity associated with imipenem\u2010cilastatin, with seizure rates ranging from 3\u201333%. For meropenem, doripenem, and ertapenem, the seizure rate for each agent is reported as less than 1%. However, as their use increases and expands into new patient populations, the rate of seizures with these agents may increase. High\u2010dose therapy, especially in patients with renal dysfunction, preexisting central nervous system abnormalities, or a seizure history increases the likelihood of seizure activity. Although specific studies have not been conducted, data indicate that carbapenem\u2010associated seizure is best managed with benzodiazepines, followed by other agents that enhance GABA transmission. Due to the drug interaction between carbapenems and valproic acid, resulting in clinically significant declines in valproic acid serum concentrations, the combination should be avoided whenever possible. Clinicians should be vigilant regarding the possibility of carbapenem\u2010induced seizures when selecting and dosing antimicrobial therapy.<\/jats:p>","DOI":"10.1592\/phco.31.4.408","type":"journal-article","created":{"date-parts":[[2011,3,25]],"date-time":"2011-03-25T13:20:02Z","timestamp":1301059202000},"page":"408-423","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":93,"title":["Epileptogenic Potential of Carbapenem Agents: Mechanism of Action, Seizure Rates, and Clinical Considerations"],"prefix":"10.1002","volume":"31","author":[{"given":"April D.","family":"Miller","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda M.","family":"Ball","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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