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Antimicrobial-induced cognitive side effects

Amanda Warstler1, Jennifer Bean2

  • 1PGY2 Psychiatric Pharmacy Resident, Department of Veterans Affairs, Tennessee Valley Healthcare System, Murfreesboro, Tennessee, amanda.warstler@va.gov.

The Mental Health Clinician
|June 30, 2018
PubMed
Abstract

Insights

Antimicrobial drugs can cause cognitive side effects like confusion and delirium, often underreported. Recognizing these effects and risk factors is crucial for patient care and pharmacist intervention.

Area of Science:

  • Pharmacology
  • Neuroscience
  • Infectious Diseases

Background:

  • Antimicrobial-induced cognitive side effects are frequently overlooked and misclassified.
  • Symptoms are often reported under broader terms like neurotoxicity or encephalopathy.

Purpose of the Study:

  • To review and summarize antimicrobial-induced cognitive side effects.
  • To highlight risk factors, clinical symptoms, and mechanisms.
  • To inform clinical practice and patient management.

Main Methods:

  • Conducted a PubMed search using keywords related to antimicrobials and cognitive impairment.
  • Analyzed case reviews, reports, and cohort studies.
  • Excluded studies on neuropsychiatric effects, animal studies, and antiretrovirals.

Main Results:

  • Identified confusion, delirium, encephalopathy, and impaired attention as common side effects across antimicrobial classes.
  • Older age and renal impairment were recurring risk factors.
  • Mechanisms of cognitive impairment varied by antimicrobial class.

Conclusions:

  • Increased awareness of antimicrobial-induced cognitive side effects is critical for diagnosis.
  • Understanding onset time and presentation aids in challenging cases.
  • Pharmacists can prevent cognitive decline through medication adjustment and interaction awareness.
Keywords:
antibioticsantifungalsantimalarialsantiviralsbeta-lactamcephalosporincognitivedeliriumencephalopathyfluoroquinolonemacrolidemetronidazoleneurotoxicitypenicillinside effects

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