Levofloxacin-induced delirium

Abstract

An 83-year-old man was admitted for right lower lobe pneumonia which did not improve after a 5-day outpatient treatment with amoxicillin/clavulinate and clarithromycin. An empiric treatment with levofloxacin was started with a significant improvement after 24 h of this treatment. On the third day of hospitalization, delirium developed, while the patient was afebrile and with normal blood oxygenation. Treatment with levofloxacin was stopped, and a complete resolution of the patient's delirium was observed 2 days later. To the best of our knowledge, this is the third case of levofloxacin-induced delirium described in the medical literature.

Levofloxacin induced delirium with psychotic features in a young patient

“…The development of these effects seems to be related to the degree to which the fluroquinolones bind to GABA receptors and their differing potential to act as GABA antagonist and bind to the N-methyl-D-aspartate receptor. 7 There are several predisposing factors for delirium including elderly age, male gender, diabetes mellitus, hypoxemia, any neurological illness or severe atherosclerosis. Moorthy et al have described features of acute onset psychosis in an elderly male patient with uncontrolled diabetes and hypertension which recovered spontaneously on withdrawing the drug.…”

Levofloxacin-Induced Delirium: Is It a Dangerous Drug in Patients with Renal Dysfunction?

“…6,7 Delirium related to antibiotics, mainly cephalosporins, macrolides, and other fluoroquinolones, [8][9][10] has been infrequently reported, but only a few cases of levofloxacin-induced delirium have been previously published. [11][12][13][14] We described another case of delirium associated with levofloxacin in a 55-year-old male patient who was hospitalized in our medical clinic for acute renal failure and pneumonia.…”

Levofloxacin induced psychosis: a rare case report

“…7,8 The authors would like to conclude with the message that since fluoroquinolones are widely used in the treatment of various infections; hence it is important to be aware of adverse effects of these drugs. Mental state changes are rare, but may occur after levofloxacin administration as depicted in the present case.…”