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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

Summary

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.

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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.