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Levofloxacin-induced delirium

Gleb Slobodin1, Nizar Elias, Natalia Zaygraikin

  • 1Department of Internal Medicine A, Bnai Zion Medical Center, P.O. Box 6477, 31063, Haifa, Israel.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|February 4, 2009
PubMed

Insights

This case report highlights a rare side effect of levofloxacin, a common antibiotic. Delirium developed in an elderly patient treated for pneumonia, resolving after discontinuing the medication.

Area of Science:

  • Pharmacology
  • Geriatric Medicine
  • Infectious Diseases

Background:

  • Pneumonia is a common infection requiring antibiotic treatment.
  • Fluoroquinolones, such as levofloxacin, are frequently used for community-acquired pneumonia.
  • Adverse drug reactions can occur, especially in elderly patients.

Observation:

  • An 83-year-old male patient with right lower lobe pneumonia initially unresponsive to amoxicillin/clavulinate and clarithromycin.
  • Significant clinical improvement was noted within 24 hours of initiating levofloxacin therapy.
  • The patient subsequently developed delirium on the third day of hospitalization, despite being afebrile with normal oxygenation.

Findings:

  • Discontinuation of levofloxacin led to complete resolution of the patient's delirium within 48 hours.
  • This case represents the third documented instance of levofloxacin-induced delirium in medical literature.
  • The temporal association suggests a causal link between levofloxacin and the onset of delirium.

Implications:

  • Clinicians should consider delirium as a potential adverse effect of levofloxacin, particularly in the elderly.
  • Early recognition and discontinuation of the antibiotic may be crucial for managing levofloxacin-induced delirium.
  • Further research is warranted to understand the mechanisms and incidence of fluoroquinolone-associated neuropsychiatric events.

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