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Published on: October 29, 2020
Ciprofloxacin-Induced Encephalopathy
Adelle Kanan1, Alexander T Phan2, Haroon Azhand2
1California University of Science and Medicine, Colton, CA 92324 USA.
Abstract:
Fluoroquinolones (FLQs) are commonly prescribed for infections in both the inpatient and outpatient setting. Though typically well-tolerated, FLQs have been associated with central nervous system adverse effects, especially in older adults and those who metabolize medications at suboptimal rates. Rarely, these drugs can cause serious neurotoxic manifestations, such as seizures, psychosis, or encephalopathy. Although new quinolone derivatives like levofloxacin are most associated with neurotoxic side effects, we show that these unwanted side effects can occur with ciprofloxacin as well. Clinicians should be aware of the neurotoxic side effects of FLQs and its predisposing risk factors, as this is a commonly prescribed class of medication. We aim to contribute to the limited body of literature describing neurotoxic clinical manifestations of FLQs. Herein, we present a case of an 88-year-old male with underlying dementia who presented to the emergency department for evaluation of acute encephalopathy.
Insights
Fluoroquinolones (FLQs) can cause serious neurotoxic effects like encephalopathy, even with common drugs like ciprofloxacin. Older adults and those with cognitive issues are at higher risk for these central nervous system adverse effects.
Area of Science:
- Pharmacology
- Neuroscience
- Infectious Diseases
Background:
- Fluoroquinolones (FLQs) are widely prescribed antibiotics for various infections.
- While generally safe, FLQs are linked to central nervous system (CNS) adverse effects, particularly in vulnerable populations.
- Serious neurotoxic events, including seizures and encephalopathy, are rare but documented FLQ side effects.
Observation:
- This report details a case of acute encephalopathy in an 88-year-old male with pre-existing dementia.
- The patient's presentation was evaluated in the emergency department.
- The case highlights the potential for FLQs to cause neurotoxicity.
Findings:
- Neurotoxic side effects of FLQs, such as encephalopathy, can occur with ciprofloxacin, not just newer derivatives like levofloxacin.
- Predisposing factors include advanced age and impaired medication metabolism.
- The study contributes to understanding the clinical manifestations of FLQ-induced neurotoxicity.
Implications:
- Clinicians must be vigilant regarding the potential neurotoxic side effects of fluoroquinolones.
- Awareness of risk factors is crucial for early identification and management of FLQ-related CNS events.
- This case underscores the importance of considering medication side effects in elderly patients with cognitive decline and acute neurological symptoms.
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