Clarithromycin-induced hypomania in a child - a case report

Area of Science:

• Pediatric Psychiatry
• Pharmacovigilance
• Adverse Drug Reactions

Background:

• Antibiotics are widely prescribed for pediatric infections.
• Understanding potential neuropsychiatric side effects of common medications is crucial.

Observation:

• A 3-year-old boy was treated with oral clarithromycin for pneumonia.
• Following clarithromycin administration, the child exhibited increasing hyperactivity, irritability, psychomotor agitation, pressured speech, and insomnia.

Findings:

• The clinical presentation was consistent with hypomania.
• Discontinuation of clarithromycin led to a gradual resolution of hypomanic symptoms within 36 hours.
• Clarithromycin was identified as the likely cause of the adverse reaction.

Implications:

• This case highlights uncommon but significant adverse psychiatric reactions associated with commonly used antibiotics.
• Clinicians, including general practitioners, pediatricians, and child psychiatrists, should consider medication side effects when evaluating behavioral changes in children.
• Increased awareness of potential neuropsychiatric effects can improve patient safety and management.