Cephalosporins are epileptogenic
drugs, especially when excessive dosages are used or when the
drugs are used in
patients with decreased renal clearance. The present case
report showed that a chronic
kidney patient receiving
hemodialysis developed generalized tonic clonic seizures when an inappropriate high
dose cefazolin was given.
Cefazolin 2 g iv q 8 h was given for 25 days continuously to treat
fever of unknown origin in a
patient who was a severe renal impairment
patient. In a severe renal impairment
patient, the
maintenance dose of
cefazolin should be reduced by half and the interval for
administration should be extended to 24 h. Even though
hemodialysis could remove
cefazolin from the
blood circulation, in the presented case the very high
dose of
cefazolin given was far beyond the
ability of
hemodialysis to clear the
drug. The accumulation ofcefazolin, therefore, induced three episodes of seizures on days 14, 21 and 25. More
precaution should be taken when prescribing medication to a
patient with
predisposing factors.