Cepbaloridlne

EDI:e,II.lo,.tby Following an operation to fashion a caecostomy in a 62.year·old female. she was given 3litres/day of IV fluid. each litre containing cephaloridine 2g and metronidazole 500g. Because of abnormally low urine output, the observance of drowsiness. muscle twitching. and other signs. renal failure was suspected 4 days after the operation. Antibiotics were stopped, rehydration begun. and the patient put on to haemodialysis as anuria was established. Serum cephaloridine was 48mg/L at 24 hrs after drug withdrawal with a CSF level of 1.4mg/L four days later. Although spontaneous respiration, eye, head, and some limb movements returned. her conscious level continued to decline. Renal function became sufficient to maintain serum creatinine concentration at about 900J,lmoI/UIO.lmg/lOOmO. No further neurological improvement occurred. She developed hrondlopneumonia and died nearly seven weeks after receiving cephaloridine. Histological examination of the brain revealed diffuse neuronal degeneration. The authors point out the need to be aware of the enoephalopathic potential of this drug. especially in the presence of kidney failure, which in this case may also have heen related to the drug. Taylor. R. 0 .. 1. , British Medical Joumal 283, 40918 Aug 198 J)

4 Reactions 4 Sep 1981 0157· 7271 / 81 /0904-0004 / 0$00.50/0 c AOtS Press