Serum concentrations of valproate were reduced and seizures were exacerbated by concomitant meropenem therapy in a child with a neurodegenerative disorder and epilepsy. In this patient, a rapid decline of valproate serum concentrations was observed on two occasions with meropenem antibiotic therapy. This event was the most likely cause of observed seizure exacerbation. Meropenem should be used with caution in patients treated with valproate owing to the drastic lowering of serum valproate concentration and the consequent risk of seizure worsening. (J Child Neurol 2005;20:456—457).
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References
1.
De Turck Bjg , Diltoer MW, Cornelis Pjww, et al: Lowering of plasma valproic acid concentrations during concomitant therapy with meropenem and amikacin. J Antimicrob Chemother1998;42:563—564.
2.
Santucci M., Ambrosetto G., Scaduto MC, et al: Ictal and nonictal paroxysmal events in infantile neuroaxonal dystrophy: Polygraphic study of a case. Epilepsia2001;42:1074—1077.
3.
Nagai K., Shimizu T., Togo A., et al: Decrease in serum levels ofvalproic acid during treatment with a carbapenem, panipenem/betamipron. J Antimicrob Chemother1997;39:295—296.
4.
Yamagata T., Momoi MY, Murai K., et al: Panipenem-betamipron and decreases in serum valproic acid concentration . Ther Drug Monit1998;20:396—400.
5.
Bax RP, Bastain W., Featherstone A., et al: The pharmacokinetics of meropenem in volunteers. J Antimicrob Chemother1989;24(Suppl): 311—320.
6.
Nakashima M. , Uematsu T., Kanamaru M., et al: Phase I study of panipenem/betamipron II multiple dose study. Chemotherapy ( Tokyo) 1991;39(Suppl):265—288.
7.
Yokogawa K., Twashita S., Kubota A., et al: Effect of meropenem on disposition kinetics of valproate and its metabolites in rabbits. Pharm Res2001 ;18:1320—1326.
8.
Hsu HL, Lu CY, Tseng HY, et al: Empirical monotherapy with meropenem in serious bacterial infections in children. J Microbiol Immunol Infect2001 ;34:275—280.
9.
De Sarro A., Imperatore C., Mastroemi P., de Sarro G.: Comparative convulsant potencies of two carbapenem derivatives in C57 and DBA/2 mice. J Pharm Pharmacol1995;47:292—296.
10.
Norrby SR: Neurotoxicity of carbapenem antibacterials. Drug Saf1996;15:87—90.
