Cephalosporin-induced Neurotoxicity

The product information documents of many cephalosporin products have recently been updated to include warnings of neurotoxicity. Cephalosporins are broad-spectrum beta-lactam antibiotics that are commonly used to treat a range of infections. Neurotoxicity has been reported with their use and may present as encephalopathy, seizures, or myoclonus.

Risk factors for developing neurotoxicity during cephalosporin treatment include:

• Older age;
• Renal impairment (especially if doses are not adjusted appropriately);
• Underlying central nervous system disorders; and
• Intravenous administration.

The onset of neurotoxicity is typically one to ten days after initiating the antibiotic, with resolution reported to occur two to seven days after discontinuation. Symptoms of cephalosporin-induced neurotoxicity have the potential to be incorrectly attributed to another neurological condition or metabolic abnormality, particularly in hospitalised patients. Therefore, a high degree of suspicion is required in order to recognise this adverse event in a timely manner.