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Gemifloxacin-associated neurotoxicity presenting as encephalopathy
Matthew J Barrett1, Ivan S Login
1Department of Neurology, University of Virginia Health System, Charlottesville, USA.
The Annals of Pharmacotherapy
|March 12, 2009
Summary
Gemifloxacin, a fluoroquinolone antibiotic, may cause acute encephalopathy, a severe central nervous system adverse effect. This case highlights the need to consider gemifloxacin when evaluating patients with unexplained encephalopathy.
Area of Science:
- Neuroscience
- Pharmacology
- Infectious Diseases
Background:
- Fluoroquinolones are broad-spectrum antibiotics with known neurotoxic potential.
- Reported central nervous system adverse effects include encephalopathy, seizures, and toxic psychosis.
- Gemifloxacin is a fluoroquinolone, but specific reports of encephalopathy are lacking.
Purpose of the Study:
- To report a case of acute encephalopathy potentially associated with gemifloxacin ingestion.
- To raise awareness of gemifloxacin as a possible cause of neurotoxicity.
Main Methods:
- Case report of a 67-year-old woman presenting with acute encephalopathy.
- Diagnostic workup excluded structural, metabolic, and infectious causes.
- Causality assessment suggested probable association with gemifloxacin use.
Main Results:
- The patient developed acute encephalopathy after taking gemifloxacin.
- Mental status normalized within 2 days without specific treatment.
- Electroencephalogram revealed a predisposition to seizures, possibly unmasked by gemifloxacin.
Conclusions:
- Gemifloxacin, like other fluoroquinolones, can cause severe central nervous system adverse effects, including encephalopathy.
- Gemifloxacin should be considered in the differential diagnosis of acute encephalopathy.
- This case expands the known neurotoxic profile of fluoroquinolones.
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