Intentional use of carbapenem antibiotics for valproic acid toxicity: A case report.

TitleIntentional use of carbapenem antibiotics for valproic acid toxicity: A case report.
Publication TypeJournal Article
Year of Publication2018
AuthorsKhobrani MA, Dudley SW, Huckleberry YC, Kopp BJ, Biggs AD, French RNE, Shirazi FM, Erstad BL
JournalJ Clin Pharm Ther
Date Published2018 Oct
ISSN Number1365-2710
KeywordsAnticonvulsants, Carbapenems, Drug Interactions, Humans, Male, Meropenem, Middle Aged, Valproic Acid

WHAT IS KNOWN AND OBJECTIVE: The interaction between valproic acid (VPA) and carbapenem antibiotics is well described with previous reports suggesting a reduction in VPA half-life between 47% and 90%. As described in this case, this interaction might be beneficial in the setting of toxic VPA ingestion.

CASE DESCRIPTION: An intubated, unresponsive patient arrived via emergency medical services after toxic VPA ingestion. Meropenem was prescribed for a suspected pneumonia and to take advantage of the VPA interaction. We observed a 56% decline in half-life with short-term meropenem dosing and an improvement in mental status shortly after administration.

WHAT IS NEW AND CONCLUSION: Our findings suggest a potential role for short-term carbapenem therapy for VPA overdose.

Alternate JournalJ Clin Pharm Ther
PubMed ID29733112
Faculty Reference: 
Robert N.E. French, MD, MPH
Farshad "Mazda" Shirazi, MD, PhD, FACEP, FACMT