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Cefixime-induced Oromandibular Dystonia in an Adult: A Case Report
Lisa Mondet1, Fanny Radoubé1, Valérie Gras2
1Régional Pharmacovigilance Centre, Amiens University Hospital, Amiens,France.
Introduction:
Cefixime, a third-generation cephalosporin, is commonly used in different infections. Tolerance is pretty good even if some side effects can be frequent like digestive disorders. Other effects, not mentioned in the Summary of Product Characteristics, can occur.
Methods:
We report a case of recurrent, acute oromandibular dystonia in a cefixime-treated adult.
Case-Report:
After the third dose of cefixime, prescribed for a bronchial infection, a patient experienced a first episode of oromandibular dystonia. Then, after each ingestion, the same effects appeared. After the discontinuation of cefixime, there was no recurrence. The diagnosis of acute oromandibular dystonia has been confirmed by a neurologist.
Discussion:
Some cases of dystonia have been published with other β-lactams antibiotics and with cefixime but they concerned children. Different mechanisms are proposed to explain the occurrence of dystonia during a treatment with cefixime. They involved certain neurotransmitters like dopamine, acetylcholine or GABA.
Conclusion:
Even if dystonia is not a side effect mentioned in the SPC, the drug's potential causal role must always be considered in case of involuntary contraction of muscles in a patient treated with cefixime or any other β-lactam antibiotics.
Insights
Cefixime, a third-generation cephalosporin, can cause oromandibular dystonia, a rare side effect. This case highlights the potential for involuntary muscle contractions with cefixime, even if not listed in its product characteristics.
Area of Science:
- Pharmacology
- Neurology
- Infectious Diseases
Background:
- Cefixime, a third-generation cephalosporin antibiotic, is widely used for various infections.
- While generally well-tolerated, cefixime can cause side effects, including digestive issues, and potentially unlisted adverse events.
- Oromandibular dystonia is a movement disorder characterized by involuntary muscle contractions in the jaw, tongue, and face.
Purpose of the Study:
- To report a case of recurrent acute oromandibular dystonia in an adult patient treated with cefixime.
- To highlight a potential, albeit rare, neurological side effect of cefixime not typically listed in its product information.
- To contribute to the understanding of cefixime's potential adverse effects beyond common gastrointestinal disturbances.
Main Methods:
- A case report detailing an adult patient's experience with cefixime.
- Documentation of the onset, recurrence, and resolution of oromandibular dystonia symptoms.
- Neurological confirmation of the acute oromandibular dystonia diagnosis.
Main Results:
- The patient experienced recurrent episodes of acute oromandibular dystonia after each dose of cefixime.
- Symptoms resolved completely upon discontinuation of the cefixime treatment.
- The diagnosis was confirmed by a neurologist, establishing a clear link between cefixime and the dystonic episodes.
Conclusions:
- Dystonia, including oromandibular dystonia, has been associated with other beta-lactam antibiotics and rarely with cefixime, particularly in pediatric cases.
- Potential mechanisms involve neurotransmitter pathways, including dopamine, acetylcholine, and GABA.
- Clinicians should consider cefixime and other beta-lactam antibiotics as potential causes of dystonia, even if not listed as a known side effect in the Summary of Product Characteristics.
