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How epileptogenic are the recent antibiotics?
P Hantson1, F Léonard, J M Maloteaux
1Department of Intensive Care, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium. hantson@rean.ucl.ac.be
Acta Clinica Belgica
|July 8, 1999
Summary
Recent antibiotics, particularly cephalosporins and fluoroquinolones, can cause serious neurologic adverse events like seizures by affecting the GABA receptor. Clinicians should consider patient factors and drug metabolism to minimize risks.
Area of Science:
- Pharmacology
- Neuroscience
- Clinical Medicine
Background:
- Antibiotics, including cephalosporins, monobactams, carbapenems, and fluoroquinolones, are essential for treating infections.
- Serious neurologic adverse events, particularly seizures, have been anecdotally linked to antibiotic use.
Purpose of the Study:
- To review clinical and experimental data on antibiotic-associated serious neurologic adverse events, focusing on seizures.
- To examine the relationship between recent antibiotic classes and neurotoxicity.
Main Methods:
- Searched MEDLINE database (1966-1998) for publications on antibiotic neurotoxicity.
- Utilized keywords such as 'antibiotics,' 'neurotoxicity,' and 'seizures.'
- Included additional references from sorted articles.
Main Results:
- Antibiotic-induced neurotoxicity is infrequent but can occur.
- Experimental data suggest interaction with the gamma-aminobutyric acid (GABA) receptor complex.
- Structure-toxicity relationships are identifiable.
- Predisposing patient factors (e.g., age, CNS disorders) and drug metabolism (e.g., renal clearance, interactions) influence risk.
- Assessing causality requires considering administration delay, event evolution, risk factors, and potential rechallenge.
Conclusions:
- Antibiotics can cause neurotoxicity, potentially through GABA receptor interaction.
- Understanding predisposing factors and drug metabolism is crucial for risk mitigation.
- Careful evaluation is necessary to establish a causal link between antibiotics and neurologic events.