{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T22:31:30Z","timestamp":1792276290490,"version":"4.4.0"},"reference-count":16,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2018,12,22]],"date-time":"2018-12-22T00:00:00Z","timestamp":1545436800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Carbapenem agents are advanced derivatives of cephalosporins that are active against bacteria that produce extended spectrum beta lactamases (ESBL). These antibiotics are resistant to enzymatic cleavage, and have good central nervous system penetration. Given this fact, it is not surprising that these drugs have been reported to cause neurological side effects like seizures and encephalopathy. We report a case of a patient on hemodialytic support who had a notable change in mentation and vocal tremor. This was at first attributed to calcineurin toxicity, but after the finding of a normal tacrolimus level, ertapenem neurotoxicity was suspected. After discontinuation of the offending agent, the patient\u2019s vocal tremor, cognition, and neurological function returned to baseline levels.<\/jats:p>","DOI":"10.3390\/antibiotics8010001","type":"journal-article","created":{"date-parts":[[2018,12,24]],"date-time":"2018-12-24T10:37:49Z","timestamp":1545647869000},"page":"1","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["A Case of Ertapenem Neurotoxicity Resulting in Vocal Tremor and Altered Mentation in a Dialysis Dependent Liver Transplant Patient"],"prefix":"10.3390","volume":"8","author":[{"given":"Ramy M.","family":"Hanna","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, 700 Tiverton Ave., Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Fan","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, 700 Tiverton Ave., Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pryce","family":"Gaynor","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, 700 Tiverton Ave., Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.2165\/00003495-200767070-00006","article-title":"Comparative review of the carbapenems","volume":"67","author":"Zhanel","year":"2007","journal-title":"Drugs"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Codjoe, F., and Donkor, E.S. (2018). Carbapenem Resistance: A Review. Med. Sci., 6.","DOI":"10.3390\/medsci6010001"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Sutton, S.S., Jumper, M., Cook, S., Edun, B., and Wyatt, M.D. (2017). Ertapenem-Induced Encephalopathy in a Patient with Normal Renal Function. J. Investig. Med. High Impact Case Rep., 5.","DOI":"10.1177\/2324709616689376"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"87","DOI":"10.2165\/00002018-199615020-00001","article-title":"Neurotoxicity of carbapenem antibacterials","volume":"15","author":"Norrby","year":"1996","journal-title":"Drug Saf."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1111\/j.1365-2125.2011.03991.x","article-title":"Neurotoxic effects associated with antibiotic use: Management considerations","volume":"72","author":"Grill","year":"2011","journal-title":"Br. J. Clin. 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