Moxifloxacin Induced Seizures -A Case Report

Area of Science:

• Pharmacology
• Neurology
• Clinical Medicine

Background:

• Moxifloxacin is a fluoroquinolone antibiotic with known central nervous system (CNS) side effects.
• Seizures are a rare but serious adverse drug reaction associated with fluoroquinolones.
• Patient comorbidities and organ function can influence drug safety profiles.

Purpose of the Study:

• To report a case of generalized tonic-clonic seizure in a patient treated with moxifloxacin.
• To identify potential risk factors contributing to moxifloxacin-induced seizures in this patient.
• To discuss the implications for moxifloxacin prescribing in vulnerable populations.

Main Methods:

• Case report of a 73-year-old female patient.
• Detailed review of patient's medical history, including atrial fibrillation, intracerebral hemorrhage surgery, and impaired renal/liver function.
• Administration of moxifloxacin for appendicitis and subsequent adverse event monitoring.
• Discontinuation of moxifloxacin and switch to cefuroxime.
• Assessment of adverse drug reaction probability using the Naranjo scale.

Main Results:

• The patient developed a generalized tonic-clonic seizure on day 6 of intravenous moxifloxacin therapy.
• The Naranjo scale score indicated a possible adverse reaction to moxifloxacin (score=4).
• The patient became seizure-free after moxifloxacin discontinuation and treatment with cefuroxime.

Conclusions:

• Moxifloxacin may induce seizures, particularly in elderly female patients with lower body weight.
• Preexisting central nervous system disease and severe renal impairment are potential risk factors.
• Careful patient selection and monitoring are crucial when prescribing moxifloxacin to individuals with risk factors.