Background::
Seizures are a common presenting symptom of the central nervous system
(CNS) and could occur from infections (such as toxins) or drugs.
Objective::
The aim of this study was to present a systematic review of the association between infections,
seizures, and drugs
Methods::
Through February 18, 2024, according to the PRISMA guidelines and based on the PICO
standard format, relevant, in-depth consequent guide approach and evidence-based options
were selected associated with a knowledgeable collection of current, high-quality manuscripts.
Results::
Imbalance between inhibitory and excitatory neurotransmitters due to infections, drugs
such as ticarcillin, amoxicillin, oxacillin, penicillin G, ampicillin, tramadol, venlafaxine, cyclosporine,
tacrolimus, acyclovir, cellcept, the old generation of antiepileptic drugs, such as carbamazepine,
phenytoin, and many other drugs could cause different stages of CNS disturbances ranging
from seizure to encephalopathy. Infections could cause life-threatening status epilepticus by continuous
unremitting seizures lasting longer than 5 minutes or recurrent seizures. Meningitis, tuberculosis,
herpes simplex, cerebral toxoplasmosis, and many others could lead to status epilepticus.
In fact, confusion, encephalopathy, and myoclonus were reported with drugs, such as ticarcillin,
amoxicillin, oxacillin, penicillin G, ampicillin, and others. Penicillin G was reported as having the
greatest epileptogenic potential. A high dose, in addition to prolonged use of metronidazole, was
reported with seizure infection. Meropenem could decrease the concentration of valproic acid. Due
to the inhibition of cytochrome P450 3A4, the combination of clarithromycin and erythromycin
with carbamazepine needs vigilant monitoring.
Conclusion::
Due to changes in drug metabolism, co-administration of antiseizure drugs and antibiotics
may lead to an enhanced risk of seizures. In patients with neurocysticercosis, cerebral malaria,
viral encephalitis, bacterial meningitis, tuberculosis, and human immunodeficiency virus, the
evidence-based study recommended different mechanisms mediating epileptogenic properties of
toxins and drugs.
