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Neuropsychiatric manifestations associated with azithromycin in two brothers

Elad Schiff1, K May, L H Goldstein

  • 1Department of Internal Medicine B, B'nai Zion Medical Center, Haifa, Israel. eschiff@bezeqint.net

European Journal of Clinical Pharmacology
|September 23, 2010
PubMed
Abstract

Insights

Two brothers experienced severe neuropsychiatric events, including hallucinations and seizures, after azithromycin treatment. These rare side effects resolved over several weeks.

Area of Science:

  • Neuroscience
  • Pharmacology
  • Pediatrics

Background:

  • Azithromycin is generally considered safe, with mild neurologic adverse events in <1% of patients in premarketing trials.
  • Serious neuropsychiatric effects are rare in adults and have not been reported in pediatric populations.

Observation:

  • Two brothers, aged 6 and 15, developed severe neuropsychiatric symptoms after azithromycin.
  • Symptoms included visual/auditory hallucinations, seizures, headaches, and cortical blindness.

Findings:

  • Neuropsychiatric manifestations began within 24 hours of the first azithromycin dose.
  • Symptoms resolved gradually over 2-4 weeks.
  • This case highlights potential severe neuropsychiatric adverse events associated with azithromycin in children.

Implications:

  • Suggests a need for vigilance regarding azithromycin's neuropsychiatric effects in pediatric patients.
  • Potential genetic factors, like transporter polymorphisms, may influence susceptibility.
  • Further research into azithromycin's neurotoxicity mechanisms is warranted.

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