Cefepime-Induced Encephalopathy: Could Carnitine Deficiency Contribute toNeurotoxicity?

摘要

We read with interest the article “Cefepime-Induced Encephalopathy and Nonconvulsive StatusEpilepticus: Dispelling an Artificial Dichotomy” by Tchapyjnikov and Luedke.1 As the authors note, cefepime usually produces an encephalopathy rather thannonconvulsive status epilepticus and management should focus on supportive care and cefepimediscontinuation. Cefepime-induced neurotoxicity is likely underrecognized and underreported.We would like to comment on the mechanisms of neurotoxicity. The commonly accepted hypothesisis that cefepime-induced neurotoxicity is due to its antagonistic effect on the inhibitoryneurotransmitter, gamma-aminobutyric acid receptor.2