# Tremor as a Rare Manifestation of Cefepime Neurotoxicity

## TL;DR

An 88-year-old woman developed a tremor after receiving cefepime, a rare side effect not previously reported, highlighting the need for awareness among healthcare providers.

## Contribution

This is the first documented case of tremor as a neurotoxic side effect of cefepime.

## Key findings

- The patient developed a low-frequency tremor one day after starting cefepime treatment.
- The tremor resolved within three days after discontinuing cefepime.
- Tremor is a previously unreported neurotoxic manifestation of cefepime.

## Abstract

The antibiotic cefepime is a fourth-generation cephalosporin with extended-spectrum coverage against both gram-positive and negative bacteria. It is commonly used in the inpatient setting to treat community-acquired pneumonia or urinary tract infection and has side effects, including diarrhea, nausea, vomiting, pruritus, headache, and, more rarely, hypersensitivity reactions or neurotoxicity. The current report is about an 88-year-old female patient who was brought to the hospital by her daughter due to an acute change in mental status resulting from a urinary tract infection. The patient received intravenous cefepime and subsequently developed a low-frequency tremor after one day of treatment. Cefepime was discontinued with a resolution of tremor in three days. Though neurotoxicity has been documented as a serious adverse event with cefepime, tremor is not one of the known neurotoxic manifestations. This patient is the first reported to develop a tremor as a neurotoxic side effect from taking cefepime. Healthcare providers should be aware of this potential side effect and may consider discontinuing treatment with cefepime if their patient develops a new tremor within days of initiating treatment.