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Saudi Journal of Kidney Diseases and Transplantation
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CASE REPORT Table of Contents   
Year : 2020  |  Volume : 31  |  Issue : 6  |  Page : 1427-1431
Meropenem at recommended dose is a potential risk for seizure in hemodialysis patient

1 Department of Internal Medicine, Division of Nephrology, King Fahd Hospital of the University, Alkhobar; Department of Internal Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
2 Diaverum Al-Majdoi Dialysis Center, Eastern Province, Saudi Arabia

Correspondence Address:
Abdullah Al-Hwiesh
Department of Internal Medicine, Division of Nephrology, King Fahd Hospital of the University, Alkhobar
Saudi Arabia
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DOI: 10.4103/1319-2442.308364

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Dosage adjustment of meropenem is usually recommended in hemodialysis (HD) patients and about 30% of meropenem is cleared during regular HD sessions. However, most of the published trials excluded patients on regular HD. Little is known about the accurate dosage of meropenem needed to avoid central nervous system toxicity. Herein, we report a 65-year-old Saudi female, a known case of end-stage renal disease on regular HD, who was admitted because of pyelonephritis and started on meropenem in the recommended dose according to cultures and sensitivity. She developed tonic-clonic convulsions after the 7th dose. Seizures were completely aborted after discontinuation of the offending drug. The recommended dosage of 500 mg daily in HD patients may still be too high particularly in Asian patients owing to their relatively small body mass index.

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