Cephalexin

[dkduncan]

A patient presented to the A&E Department with a sudden onset of seizures,nil chronic illness, had five episodes within the 8 hour shift. Was given Valium and Dilantin without any effect. Recently Cephalexin was prescribed for a throat and ear infection. CT Scan normal. Pt ended in ICU with respiratory system compromise because of persistent seizures. Rare side effect of cephalexin is seizures, could this be the cause.

[BelleKat, BSN, RN]

Personally I've never heard of it,I'd be more prone to suspect that the throat/ear infection had somehow spread to his meninges to give him encephalitis or something. I'd be curious what his diagnosis ends up being.

Anything around the head in general can spread to the brain.

[LeaRNed]

Anything is possible, but it doesn't seem very likely. I take that antibiotic all the time with no problems. What is the pt's history with antibiotics?

[NRSKarenRN, BSN, RN]

medlineplus drug information: cephalexin

from: www.keflex.com

gastrointestinal

— onset of pseudomembranous colitis may occur during or after antibacterial treatment. (see warnings.) nausea and vomiting have been reported rarely. the most frequent side effect has been diarrhea. it was very rarely severe enough to warrant cessation of therapy. dyspepsia, gastritis, and abdominal pain have also occurred. as with some penicillins and some other cephalosporins, transient hepatitis and cholestatic jaundice have been reported rarely.

hypersensitivity — allergic reactions in the form of rash, urticaria, angioedema, and, rarely, erythema multiforme,

stevens-johnson syndrome, or toxic epidermal necrolysis have been observed. these reactions usually subsided upon discontinuation of the drug. in some of these reactions, supportive therapy may be necessary. anaphylaxis has also been reported.

other reactions have included genital and anal pruritus, genital moniliasis, vaginitis and lady partsl discharge, dizziness, fatigue, headache, agitation, confusion, hallucinations, arthralgia, arthritis, and joint disorder. reversible interstitial nephritis has been reported rarely. eosinophilia, neutropenia, thrombocytopenia, hemolytic anemia, and slight elevations in ast and alt have been reported.

in addition to the adverse reactions listed above that have been observed in patients treated with keflex, the following adverse reactions and altered laboratory tests have been reported for cephalosporin class antibiotics:

adverse reactions

— fever, colitis, aplastic anemia, hemorrhage, renal dysfunction, and toxic nephropathy.

several cephalosporins have been implicated in triggering seizures, particularly in patients with renal

impairment when the dosage was not reduced (see indications and usage and precautions, general).

if seizures associated with drug therapy should occur, the drug should be discontinued. anticonvulsant therapy can be given if clinically indicated.