Antibiotic-Induced Confusion

82 year old with CKD is admitted to the 2/2 STEMI. She is intubated in the ICU and days later has a new fever Antibiotics are started to cover MRSA + Pseudomonas spp. 4 days later, she has new confusion. Which antibiotic is most likely causing ?

A. Linezolid
B. Vancomycin
C. Cefepime
D. Piperacillin/tazobactam

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Best Answer:

Cefepime

Explanation: Cefepime-induced neurotoxicity may present as confusion, decreased responsiveness, myoclonus or nonconvulsive status epilepticus. Neurotoxicity should resolve after the drug is stopped.

Risk factors for cefepime neurotoxicity: -advanced age 👵🏾👴🏻🧓🏽 -critically ill -renal impairment 🫘 -previous 🧠 injury. Cefepime dose and frequency should be adjusted based on a patient’s renal function to help ⬇️ risk.