Meropenem-Associated Encephalopathy (Neurotoxicity)
Meropenem can cause adverse central nervous system (CNS) effects, including encephalopathy and seizures. [1] Cases of acute encephalopathy temporally associated with meropenem administration have been reported. [2]
FDA-Listed CNS Adverse Effects
The meropenem prescribing information states that seizures and other adverse CNS experiences have been reported during treatment. [1] CNS adverse events reported with meropenem can include encephalopathy and related manifestations such as confusion and tremor. [3]
Clinical Pattern and Differential Considerations
Meropenem-related neurotoxicity can present as altered mental status and other acute neurologic changes. [1] Alternative causes such as sepsis-associated encephalopathy, metabolic derangements, and CNS infection should be considered when encephalopathy occurs during therapy. [2]
Risk Factors for Carbapenem Neurotoxicity
Risk factors for carbapenem neurotoxicity include prior CNS abnormalities, renal dysfunction, and concomitant medications with seizure potential. [1]
Treatment Approach When Suspected
Meropenem should be discontinued when clinically suspected neurotoxicity is present. [1] Seizures should be treated with appropriate anticonvulsant therapy when they occur during meropenem treatment. [1]
Incidence of Seizures (Related CNS Toxicity)
In non-meningitis infections, seizures judged related to meropenem treatment occurred at an incidence of 0.07% in an updated safety analysis. [4]
Conclusion
Meropenem can cause encephalopathy as part of carbapenem-associated neurotoxicity, with seizures representing the best-characterized CNS manifestation. [1]