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[Acute delirium, probably precipitated by clarithromycin].

A H Pijlman1, E M Kuck, E P van Puijenbroek

  • 1Afd. Interne Geneeskunde, Diakonessenhuis, Bosboomstraat 1, 3582 KE Utrecht. apijlman@diakhuis.nl

Nederlands Tijdschrift Voor Geneeskunde
|February 24, 2001
PubMed
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Clarithromycin, an antibiotic, may cause delirium, particularly in elderly patients. This side effect, though rare, is linked to Helicobacter pylori treatment and warrants further investigation.

Area of Science:

  • Pharmacology
  • Neuroscience
  • Infectious Diseases

Background:

  • Clarithromycin is a widely used macrolide antibiotic.
  • Its efficacy in treating Helicobacter pylori infections is well-established.
  • Potential adverse effects require ongoing surveillance.

Observation:

  • Two patients, aged 74 and 56, developed delirium post-clarithromycin treatment.
  • The delirium was associated with Helicobacter pylori eradication therapy.
  • This suggests a potential idiosyncratic reaction to clarithromycin.

Findings:

  • Preclinical and clinical studies have not previously identified central nervous system side effects.
  • Multiple case reports now describe delirium linked to clarithromycin use.
  • Positive rechallenge in some patients strengthens the association.

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Implications:

  • A probable causal relationship exists between clarithromycin and delirium.
  • Healthcare providers should be vigilant for psychiatric side effects, especially delirium.
  • Further research is needed to understand the mechanism and incidence of this adverse event.