BARDIN C, LEJOUAN M, HAVARD L, BATISTA R, BOUCHAND F, CHAST F; Interscience Conference on Antimicrobial Agents and Chemotherapy (42nd : 2002 : San Diego, Calif.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2002 Sep 27-30; 42: abstract no. A-1273.
Hotel-Dieu Hospital, Paris, France
BACKGROUND:: Acyclovir is a usually well-tolerated antiherpetic agent. Confusion, hallucinations, seizures and coma are rare but have been reported in patients with renal failure. No clear concentration side-effects relationship has been established. The aim of our study was to evaluate the correlation between acyclovir serum concentration and clinical neurotoxicity. METHODS: Trough serum concentrations of acyclovir were measured at steady-state in 74 immunocompromised adult patients (mainly after organ transplantation) who developed neurotoxicity or with a risk of toxicity (patients with impaired renal function). Acyclovir assay was performed by high performance liquid chromatography at 245 nm [sensitivity of the assay was 0.1 mg/L acyclovir]. Trough serum levels were chosen as a parameter which reflect better drug exposure and elimination process. RESULTS: 33 patients developed neurotoxicity (impaired consciousness and hallucinations 60%, tremor and myoclonus 16%, encephalopathy 15%, coma 9%). 41 patients had no sign of neurotoxicity. Mean serum level of acyclovir was higher in patients with neurotoxicity compared to patients without neurotoxicity (table below: mean +/-SD). Our findings could underestimate correlation because of a delayed neurologic toxicity (1-2 days) after peak concentration. Conclusion: Our results suggest that monitoring of trough acyclovir serum concentration in patients with impaired renal function could be useful to avoid drug accumulation of acyclovir and reduce risk of its neurotoxicity. [table: see text]
Publication Types:
Keywords:
- Acyclovir
- Adult
- Attention
- Brain Diseases
- Coma
- Confusion
- Humans
- Kidney Failure
- Neurotoxicity Syndromes
- Seizures
- adverse effects
Other ID:
UI: 102267249
From Meeting Abstracts