Ertapenem-Induced Delirium

Neurotoxicity is an unusual iatrogenic effect associated with carbapenems, typically manifested as seizures or hyperactive delirium. We present 89-year-old female patient a medical history of hypertension and chronic kidney disease who was admitted for acute tracheobronchitis anemia related to diverticular disease. As complication, she developed cystitis caused by extended spectrum ß-lactamases producing Klebsiella pneumoniae, so intravenous ertapenem started. On the second day antibiotic therapy, visual hallucinations followed inattentive lethargic state suggestive hypoactive An ertapenem-induced neurotoxicity suspected. Upon substitution meropenem, improved, symptom reversal occurred after 72 hours. review address pharmacokinetics aspects namely renal dysfunction hypoalbuminemia that could potentiate encephalopathy. Although rare, clinicians should be aware non-seizure neurotoxicity. Ready recognition can lead rapid improvement prevent dire outcomes.