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.
Keywords: carbapenem interaction; valproic acid interaction; valproic acid overdose; valproic acid toxicity.
© 2018 John Wiley & Sons Ltd.