{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:28:50Z","timestamp":1787030930618,"version":"build-2736575974"},"reference-count":24,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>We present a case of severe cefepime-induced neurotoxicity following acute kidney injury in a patient with a fracture-related infection. Despite stopping cefepime, the patient required intubation, ventilation, multiple antiepileptic drugs for seizure control, and haemodialysis.\n\nContribution: Cefepime-induced neurotoxicity is a reversible cause of encephalopathy. Early recognition and cefepime withdrawal are crucial. As cefepime use in South Africa increases due to antimicrobial resistance, healthcare workers must be aware of this under-recognised, under-reported serious adverse drug reaction.\n\nKeywords: cefepime; neurotoxicity; cefepime-induced neurotoxicity; adverse drug reaction; encephalopathy.<\/jats:p>","DOI":"10.4102\/sajid.v40i1.704","type":"journal-article","created":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T09:34:02Z","timestamp":1745660042000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Cefepime-induced neurotoxicity"],"prefix":"10.4102","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2705-1759","authenticated-orcid":false,"given":"Jessica","family":"Taylor","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03p74gp79","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Cape Town"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3027-0602","authenticated-orcid":false,"given":"Hannah M.","family":"Gunter","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03p74gp79","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Cape Town"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1892-4207","authenticated-orcid":false,"given":"Karen","family":"Cohen","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03p74gp79","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Cape Town"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"key":"ref0","unstructured":"CEFIPIME FOR INJECTION [package insert]. Lake Forest, IL: Hospira Inc.; 1996 (revised 2019). [cited 2025 Mar 11]. Available from: https:\/\/labeling.pfizer.com\/ShowLabeling.aspx?id=13898"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Ajibola O, Aremu TO, Dada SO, et al. The trend of cefepime-induced neurotoxicity: A systematic review. Cureus. 2023;15(6):e40980. https:\/\/doi.org\/10.7759\/cureus.40980","DOI":"10.7759\/cureus.40980"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Payne LE, Gagnon DJ, Riker RR, et al. Cefepime-induced neurotoxicity: A systematic review. Crit Care. 2017;21(1):276. https:\/\/doi.org\/10.1186\/s13054-017-1856-1","DOI":"10.1186\/s13054-017-1856-1"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Jeon J, Cho YW, Moon HJ. Cefepime-induced encephalopathy in a Tertiary Medical Center in Korea. J Clin Neurol. 2020;16(3):408\u2013415. https:\/\/doi.org\/10.3988\/jcn.2020.16.3.408","DOI":"10.3988\/jcn.2020.16.3.408"},{"key":"ref4","unstructured":"Garces EO, Andrade de Anzambuja MF, Da Silva D, Bragatti JA, Jacoby T, Saldanha Thom\u00e9 F. Renal failure is a risk factor for cefepime-induced encephalopathy. J Nephrol. 2008;21(4):526\u2013534."},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Fugate JE, Kalimullah EA, Hocker SE, Clark SL, Wijdicks EFM, Rabinstein AA. Cefepime neurotoxicity in the intensive care unit: A cause of severe, underappreciated encephalopathy. Crit Care. 2013;17(6):R264. https:\/\/doi.org\/10.1186\/cc13094","DOI":"10.1186\/cc13094"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Roger C, Louart B. Beta-lactams toxicity in the intensive care unit: An underestimated collateral damage? 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