Ertapenem-induced delirium

Abstract

Introduction: Ertapenem is an intravenous antibiotic within the class of carbapenem antibiotics which are highly effective against severe bacterial infections. These antibiotic agents exhibit a wider spectrum of action when compared to penicillins and cephalosporins despite carbapenems being part of the beta-lactam antibiotic class.

Case presentation: The patient is an 85-year old gentleman who developed a lower urinary tract infection and left 4th toe osteomyelitis. Ertapenem was prescribed according to the sensitivities of the cultured organisms. After two weeks of antibiotic treatment the patient developed new-onset delirium, agitation, hallucinations and throat discomfort. Ertapenem was stopped and the new symptoms resolved within 48 hours.

Discussion: Delirium, agitation, hallucinations and throat discomfort are rare but documented side-effects of ertapenem. In such cases the withdrawal of ertapenem results in a resolution of symptoms.