Imipenem-induced seizure: a case of inappropriate, excessive, and prolonged surgical prophylaxis.

Imipenem-cilastatin is a broad spectrum antibiotic that is generally used for antibiotic-resistant hospital-acquired infections. Imipenem has been reported to cause CNS toxicity including seizures in 1.5-10% of patients. The authors present a case in which imipenem, inappropriately utilized for surgical prophylaxis in excessive doses (1 gram every six hours) and for a prolonged period of time (24 days), induced a tonic-clonic generalized seizure in a patient with no history of seizure activity. The identification of this ADR lead to a number of clinical and administrative actions within our institution. Drug-induced seizures have occurred and will continue to occur as healthcare professionals exceed recommended dosing guidelines to treat critically ill patients. As pharmacists, it is extremely important to use therapeutic drug monitoring and pharmaceutical care principles to assist physicians in individualizing drug regimens for our patients to prevent these ADRs from occurring, thereby significantly effecting patients' outcomes.