A Retrospective Study on the Incidence of Seizures among Neurosurgical Patients Who Treated with Imipenem/Cilastatin or Meropenem
Objective: We sought to evaluate the safety of imipenem and meropenem in the treatment of infections in
neurosurgical patients. Methods: An observational retrospective study was conducted of consecutive cases treated with
imipenem from Sept. 2007 to Sept. 2009 and meropenem within 1 year from Sept. 2008 in Beijing Tiantan Hospital,
China. Data including the dosage and duration of the drug use, occurrence of seizures and mortality outcome was collected
from the electronic pharmacy records. The incidence of epilepsy, epileptic standardized morbidity rate (SMR) were
reported. Attention was paid to the relationship between the use of imipenem/meropenem and the incidence of epilepsy.
Results: The imipenem patients within two years amounted to 71, with mean age 45.9±20.2 years, male to female ratio
46/25. The incidence of epilepsy was 11.3% (8 cases). Among them, 1 case occurred during treatment (1/633, 1.6/1000
patient-days), and the remaining 7 cases occurred before treatment (7/2819, 2.5/1000 patient-days), with the standardized
incidence rate 0.64, 95% CI (0.08-5.18).The meropenem patients within one year amounted to 92, mean age 45.1±19.4
years, male to female ratio 51/41. The incidence of epilepsy was 6.5% (6 cases). 2 occurred during treatment (2/582,
2.0/1000 patients-hospital days) and 4 before treatment (4/2047, 3.4/1000 patients-inpatient days), standardized incidence
rate 1.76, 95% CI (0.32-9.63). Conclusion: Despite many other epileptogenic factors, imipenem or meropenem did not increase
the risk of seizures in neurosurgical patients. There was not further risk for patients with pre-existing seizures or
creatinine clearance abnormalities when dosed appropriate.
Keywords: Imipenem, infection, meropenem, neurosurgery, seizures.
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