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Ticino Medical Tribune
Vol. 3 No. 5-6 (2025), Articles

Cefepime and Neurotoxicity: An Underestimated Complication in the Geriatric Population

Articles
Published: 26.06.2025
DOI: https://doi.org/10.63648/sgs6vf29
Luca Barelli
University Department of Geriatric Medicine Felix Platter, Felix Platter, 4055 Basel, Switzerland
Milagros Altagracia Carela Mora
Geriatric Service, Ente Ospedaliero Cantonale (EOC), Ospedale Regionale della Beata Vergine, Mendrisio, Switzerland; Department of Medicine, Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland
Rosambra Leo
University Department of Geriatric Medicine Felix Platter, Felix Platter, 4055 Basel, Switzerland
Olivier Giannini
Department of Medicine, Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera italiana (USI), 6900 Lugano, Switzerland
Anna Acchini
Geriatric Service, Ente Ospedaliero Cantonale (EOC), Ospedale Regionale della Beata Vergine, Mendrisio, Switzerland; Department of Medicine, Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland

Keywords

cefepime
neurotoxicity
adverse effect
older patients
geriatrics
Vol. 3 No. 5-6 (2025)

Abstract

Cefepime is a widely used fourth-generation cephalosporin for the treatment of nosocomial infections but is known for its potential neurotoxicity, particularly in elderly and frail patients. This condition, characterized by cognitive impairment and confusion, occurs more frequently in the presence of renal insufficiency and/or suboptimal dosing. This paper discusses the mechanism underlying cefepime-induced neurotoxicity, the associated risk factors, and the clinical implications for monitoring and optimizing antibiotic therapy in frail patients.