Risk factors associated with the development of seizures among adult patients treated with ertapenem: A matched case-control study

doi:10.1371/journal.pone.0182046

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Title:	Risk factors associated with the development of seizures among adult patients treated with ertapenem: A matched case-control study
Authors:	Lee, Yi-Chien Huang, Yun-Jhong Hung, Miao-Chiu Hung, Sheng-Che Hsiao, Chih-Yen Cho, Hui-Ling Lai, Li-Fen Tong, Show-Hwa Wang, Jann-Tay
Contributors:	Ditmanson Med FdnChia Yi Christian Hosp, Dept Internal Med Chia Nan Univ Pharm & Sci, Dept Sports Management Ditmanson Med FdnChia Yi Christian Hosp, Dept Colorectal Surg Taipei Vet Gen Hosp, Dept Pediat Taipei Vet Gen Hosp, Dept Radiol Natl Yang Ming Univ, Sch Med Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm Ditmanson Med FdnChia Yi Christian Hosp, Dept Nursing Ditmanson Med FdnChia Yi Christian Hosp, Dept Pharm Natl Taiwan Univ Hosp, Dept Internal Med
Keywords:	Heart-Failure Bacterial-Infections Clinical-Evidence Febrile Seizures Iron-Deficiency Nervous-System Efficacy Safety Tolerability Therapy
Date:	2017-07-31
Issue Date:	2018-11-30 15:55:52 (UTC+8)
Publisher:	Public Library Science
Abstract:	Objective The purpose of this study is to compare the characteristics of those ertapenem-treated adult patients with and without development of seizures, and identify the associated factors for the development of seizures. Methods This retrospective study was conducted at Chia-Yi Christian Hospital from January 2012 to December 2014. Patients developing seizures during their ertapenem treatment course were identified as case patients. Those without seizures who had received ertapenem for at least five days were considered as the pool of control patients. For each case patient, four matched patients from the control pool were randomly selected as the final control group, based on age, gender, and the date of ertapenem prescription. Results A total of 1706 ertapenem-treated patients were identified, 33 (1.9%) individuals developed seizures with the enrollment of 132 matched control patients. Among these 33 patients, the average age was 79.3 +/- 7.5 years, and 20 (60.6%) were male. The mean Charlson co -morbidity score was 4.5 +/- 2.4, and the first episode of seizure happened 3.3 +/- 2.6 days after receiving ertapenem. In multivariate logistic regression analysis, the independent predictors associated with the development of ertapenem-associated seizures were old stroke (OR, 14.36; 95% CI, 4.38-47.02; p < 0.0001), undergoing brain images within one year prior to the admission (OR, 5.73; 95% CI, 1.78-18.43; p = 0.0034), low hemoglobin level (OR, 3.88; 95% CI, 1.28-12.75; p = 0.0165) and low platelet count (OR, 4,94; 95% CI, 1.56-15.68; p = 0.0067) at presentations, and protective factors against the development of seizures were heart failure (OR, 0.04; 95% CI, 0.00-0.63; p = 0.0222), concomitant use of steroids (OR, 0.19; 95% CI, 0.05-0.77; p = 0.0201), or antiplatelet agents (OR, 0.12; 95% CI, 0.02-0.63, p = 0.0123) with ertapenem. Conclusions The development of ertapenem-associated seizures may occur more frequently and much earlier due to its widespread use in treating drug -resistant pathogens, especially when these pathogens emerged worldwide.Our study would help physician to estimate the risk of developing seizure among patients receiving ertapenem.
Relation:	Plos One, v.12, n.7, e0182046
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Periodical Articles [Dept. of Sports Management] Periodical Articles

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