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Delirium induced by levofloxacin.

Majed Odeh1, Yana Kogan1, Alona Paz2

  • 1Department of Internal Medicine A, Bnai Zion Medical Center, Haifa, Israel; Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
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Delirium is a common, serious complication in hospitalized elders. Levofloxacin may cause delirium more often than recognized, highlighting the need for increased physician awareness of this adverse drug effect.

Keywords:
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Area of Science:

  • Geriatrics
  • Pharmacology
  • Neurology

Background:

  • Delirium is a frequent and severe complication of hospitalization in elderly patients, associated with increased morbidity and mortality.
  • Medications are a common cause of delirium, with sedatives, narcotics, and anticholinergics frequently implicated.
  • Antibiotic-induced delirium is less common, with cephalosporins and macrolides most frequently reported.

Observation:

  • Delirium associated with fluoroquinolones is rare, with only eight cases of levofloxacin-induced delirium documented globally.
  • This report details an additional case of levofloxacin-induced delirium in an elderly patient with acute bronchitis.
  • Three cases from a single medical ward suggest significant under-recognition of levofloxacin-induced delirium.

Findings:

  • The under-diagnosis of drug-induced delirium, particularly levofloxacin-induced delirium, is widespread among physicians.
  • Levofloxacin-induced delirium may be a more prevalent adverse effect than currently reported in medical literature.
  • Physicians need greater awareness of this serious, potentially reversible central nervous system complication.

Implications:

  • Increased physician awareness is crucial for the timely detection and management of levofloxacin-induced delirium.
  • Early recognition can prevent prolonged hospitalization and reduce patient morbidity and mortality.
  • Further research is needed to understand the full incidence and risk factors associated with levofloxacin-induced delirium.