International Journal of Clinical Pharmacy

, Volume 35, Issue 5, pp 683–687 | Cite as

Comparison of the prevalence of convulsions associated with the use of cefepime and meropenem

  • Akihiro TanakaEmail author
  • Kenshi Takechi
  • Shinichi Watanabe
  • Mamoru Tanaka
  • Katsuya Suemaru
  • Hiroaki Araki
Short Research Report


Background The US Food and Drug Administration reported seizures associated with the use of cefepime (primarily in patients with renal impairment who did not receive appropriate dose adjustments of cefepime). Objective The maximum dose of cefepime in the USA (6 g per day) is higher than that in Japan (4 g per day). We investigated the prevalence of convulsions associated with the use of cefepime by comparing it with that of meropenem. Methods A retrospective study was undertaken in 183 patients treated with cefepime and 745 patients treated with meropenem over 2 years at Ehime University Hospital. Cefepime or meropenem-associated convulsions were defined according to the following criteria: (1) administration or dose escalation of diazepam, phenytoin, phenobarbital and thiamylal given via the intravenous route (2) convulsions recorded in medical records during administration of cefepime or meropenem. Results The prevalence of convulsions was significantly greater in the cefepime treated group than in the meropenem-treated group. Among the patients who had cefepime-associated convulsions, none had renal failure. Cefepime-associated convulsions occurred only in patients with brain disorders. Conclusion Cefepime-associated convulsions should be recognized as potential complications even in patients with normal renal function. Brain disorders may increase the risk of cefepime-associated convulsions.


Brain disorder Cefepime Convulsion Meropenem Renal function 




Conflicts of interest

The authors confirm that there are no conflicts of interest.


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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Akihiro Tanaka
    • 1
    Email author
  • Kenshi Takechi
    • 1
  • Shinichi Watanabe
    • 1
  • Mamoru Tanaka
    • 1
  • Katsuya Suemaru
    • 2
  • Hiroaki Araki
    • 1
  1. 1.Division of PharmacyEhime University HospitalToonJapan
  2. 2.School of PharmacyShujitu UniversityOkayamaJapan

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