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      Seizure propensity with imipenem.

      Archives of internal medicine
      Aged, Aged, 80 and over, Animals, Cefotaxime, administration & dosage, adverse effects, toxicity, Female, Humans, Imipenem, Male, Mice, Middle Aged, Multicenter Studies as Topic, Penicillin G, Seizures, chemically induced

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          Abstract

          Five patients with seizures related to imipenem administration are described. The potential of imipenem therapy to cause seizure was further studied in a mouse model and compared with the potential for seizure with penicillin and cefotaxime therapy. Penicillin caused ataxia and seizure at a mean mouse serum level of 5800 microns/mL, cefotaxime at 3400 microns/mL, and imipenem at a much lower serum concentration of 1900 microns/mL. The potent activity of imipenem therapy against bacteria, allowing for a clinical dose of only 2 g/d, is unfortunately offset by its higher propensity to induce neurologic symptoms in humans and mice at much smaller doses than would therapy with penicillin G or the cephalosporins, such as cefotaxime.

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