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.


  1. Ajibola O, Aremu TO, Dada SO, Ajibola O, Adeyinka KO, Ajibola A, et al. The trend of cefepime-induced neurotoxicity: a systematic review. Cureus 2023; 15(6).

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