Central nervous system toxicity of quinolones: human and animal findings

Quinolones have been reported to induce CNS reactions in 0.9-2.1% of cases, but severe reactions occur in less than 0.5%. Flumequine and fleroxacin, but not other quinolones, have produced convulsions in animals after systemic administration; by interventricular injection convulsions could be produced by some quinolones, but by pefloxacin only when a dose of 400 micrograms was reached. A possible mechanism for CNS excitation may be the displacement of GABA from receptors. Quinolones may interact with other drugs--theophylline, caffeine, non-steroidal anti-inflammatory drugs--in producing CNS effects.