Table 1 Summary of selected reports of seizure adverse events in patients receiving imipenem or meropenem

Imipenem

   Winston et al. 1984 [24]

35 patients with infections from imipenem-susceptible organisms

4 g/day (23 patients); <4 g/day (12 patients)

None

   Calandra et al. 1985 [17]

First 2,516 patients treated; most had significant background disorders

<2 g/day, 32 percent; 2 g/day, 44 percent; >2 g/day, 24 percent

1.5 percent (37/2,516) all episodes; 0.24 percent (6/2,516) imipenem related

High rates of central nervous system disorders in patients with seizures

   Winston et al. 1988 [25]

29 febrile granulocytopenic patients

1 g q6h

10.3 percent (3/29)

Versus 0 percent (0/58) treated with 2 β-lactams

   Eng et al. 1989 [4]

First 22 patients treated

Varied (500 mg q12h to 1 g q6h)

22.7 percent (5/22)

   Rolston et al. 1992 [22]

371 febrile neutropenic cancer patients

12.5 mg/kg q6h

1.5 percent (3/196) imipenem + vancomycin; 3.4 percent (6/175) imipenem + amikacin

1 g qh6 for an 80 kg patient

   Norrby et al. 1993 [19]

197 patients with severe nosocomial infections

500 mg q6h adjusted for renal dysfunction

0.5 percent (1/197)

Versus 0 percent (0/196) treated with ceftazidime

   Raad et al. 1996 [21]

198 febrile neutropenic cancer patients

500 mg q6h

0.5 percent (1/198) imipenem + vancomycin

Versus 0 percent (0/192) treated with aztreonam + vancomycin

   Karadeniz et al. 2000 [18]

82 pediatric patients with malignancies

50 mg/kg/day in 3 doses

3.6 percent (3/82)

   Koppel et al. 2001 [3]

98 patients

Max. 2 g/day

4.0/1,000 patient-days (on imipenem); 3.9/1,000 patient-days (not on imipenem)

No increase in risk due to imipenem

   Winston et al. 2001 [94]

541 febrile granulocyto-penic patients

500 mg q6h

2 percent

0 percent for clinafloxacin (200 mg every 12 h); P = 0.06

Meropenem

   Sieger et al. 1997 [96]

104 patients with noso-comial lower respiratory tract infections

1 g q8h

2.9 percent (3/104) all episodes; 0 percent meropenem related

   Norrby et al. 1999 [29]

4,872 patients in multiple trials

0.5 to 1 g q8h

Meropenem related: 0.08 percent (patients without meningitis); 0 percent (patients with meningitis)