Carbapenems and valproate: A consumptive relationship

Epilepsia Open
Peter BedeNorman Delanty

Abstract

A clinical case series is presented to characterize the interaction between carbapenem antibiotics and sodium valproate. Six illustrative cases are presented in which carbapenem therapy led to the rapid depletion of serum valproate levels, and one case is presented to demonstrate the difficulty of initiating valproate therapy in patients already on meropenem. The speed of valproate depletion after the initiation of carbapenem therapy, the effect of treatment duration, clinical manifestations, delay in valproate level normalization after carbapenem therapy, the efficacy of supplemental valproate doses, and the usefulness of valproate dose escalation are evaluated. Five out of the 7 patients became acutely symptomatic owing to their subtherapeutic valproate levels. The presented cases also highlight the relatively slow normalization of valproate levels after discontinuation of the antibiotic therapy. Our cases suggest that the interaction is not absorption-mediated because all of our patients received intravenous valproate. We observed that the introduction of alternative antiepileptic drugs (AEDs) may be preferable to valproate dose escalation, which is ineffective in the presence of concomitant meropenem therapy. The characteri...Continue Reading

References

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Citations

Aug 10, 2019·Journal of Clinical Medicine·Micheal StreinGretchen M Brophy
Dec 15, 2020·AACN Advanced Critical Care·Erin D WieruszewskiPatrick M Wieruszewski
Mar 23, 2021·Der Nervenarzt·F RosenowUNKNOWN Österreichische Gesellschaft für Neurologie (ÖGN)
Jul 3, 2021·Der Anaesthesist·Gabrielė SaitovDominik Michalski

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Methods Mentioned

BETA
bronchoalveolar lavage

Related Concepts

Related Feeds

Carbapenems (ASM)

Carbapenems are members of the beta lactam class of antibiotics and are used for the treatment of severe or high-risk bacterial infections. Discover the latest research on carbapenems here.

Carbapenems

Carbapenems are members of the beta lactam class of antibiotics and are used for the treatment of severe or high-risk bacterial infections. Discover the latest research on carbapenems here.

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