A Case of Fatal Seizure and Unconsciousness Caused

It is recognized that antibiotics which contain fl-lactam; penicillins, cephalosporines and carbapenems (imipenem/cilastatin, panipenem/betamipron and meropenem etc.) cause seizures as adverse effects1)•`5). The presence of the open /3-lacam metabolite was reported to inhibit the binding of the inhibitory neurotransmitter, gamma aminobutyric acid, to its receptor in the central nervous system (CNS), and exert a CNS stimulatory effect6). Several factors have been identified as predisposing conditions to the neurotoxicity: (1) excessive dosage, (2) renal insufficienty, (3) a pre-existing CNS disease such as a cerebrovascular accident, tumor, menignitis, head injury as well as a pyevious history of seizures, and discontinuation of anticonvulsant therapy and (4) pseudomonas aeruginosa infection1)•`5). Seizures due to carbapenems, mainly imipenem/cilastatin, were reported to occur in 2-3% of the patients1)•`5), and a more recent study reported an incidence as high as 10% in selected populations7). Panipenem/betamipron has been manufactured and sold only in Japan for 4 years, and more than 20