From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
The antibiotic of choice for patients with epilepsy should be one that has a lower risk of lowering the seizure threshold, such as beta-lactams (e.g., amoxicillin) or macrolides (e.g., azithromycin), while avoiding antibiotics known to potentially trigger seizures, such as fluoroquinolones and carbapenems, as evidenced by recent studies 1. When selecting an antibiotic for a patient with epilepsy, it is crucial to consider the potential impact on seizure threshold and the risk of drug interactions with antiepileptic medications.
- Key factors to consider include:
- The type of infection being treated
- The patient's renal function, as impaired renal function can increase the risk of seizures with certain antibiotics
- Potential interactions between the antibiotic and the patient's antiepileptic regimen
- The need for dose adjustments based on the specific antibiotic chosen and the patient's renal function Some antibiotics, such as cefepime, have been associated with non-convulsive status epilepticus even with renal dose adjustment 1, highlighting the importance of close monitoring in patients with epilepsy. In general, antibiotics with a lower proconvulsive potential, such as beta-lactams and macrolides, are preferred for patients with epilepsy, while those with a higher risk of triggering seizures, such as fluoroquinolones and carbapenems, should be avoided or used with caution 2, 3. It is also essential to monitor patients with epilepsy closely when starting a new antibiotic, watching for changes in seizure frequency or breakthrough seizures, and to be aware of the potential for non-convulsive status epilepticus, particularly with cephalosporins 3, 1.