Recurrent mania consequent to quinolones exposure: A case report and review of literature

Sahoo, Swapnajeet; Aneja, Jitender; Basu, Debasish

doi:10.4103/2249-4863.184654

Cited by 4 publications

(5 citation statements)

References 11 publications

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“…Endoplasmic reticulum stress can also be linked to diaphragmatic muscle dysfunction [30]. There are case reports in which neurological, digestive and psychiatric manifestations were attributed to the use of quinolone treatment [31,32]. Fluoroquinolones are prescribed for respiratory infections, particularly in 45-year-old or older patients.…”

Section: Manifestationsmentioning

confidence: 99%

Antibiotic-Related Adverse Events in Hospitalized Chronic Obstructive Pulmonary Disease Patients With Frequent Exacerbation: A Retrospective Study

CRETU

2023

FARMACIA

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An increased risk of neuro-psychiatric related adverse events among fluoroquinolones (levofloxacin or ciprofloxacin) and ceftriaxone users was reported in primary care of hospitalized patients with Chronic Obstructive Pulmonary Disease (COPD). We evaluated the rate of antibiotic-related neuro-psychiatric adverse events during hospitalizations in patients with recurrences for COPD exacerbations. A single-center, cross-sectional, retrospective study was carried out in the Pulmonary Diseases Hospital including hospitalizations for COPD exacerbations from June 2014 to May 2019. Including criteria: > 40 years, > 2 hospitalizations for a patient in a year, at least one early re-admission < 30 days and treatment with at least one antibiotic of >24 hours. Fragile COPD patients, asthma, tuberculosis, cancer, known neurological or psychiatric diseases were excluded. Hospitalizations were divided into fluoroquinolone and non-fluoroquinolone treatments. Non-fluoroquinolone treatment was predominant (72.21% of hospitalizations). Neuro-psychiatric events were significantly higher in the fluoroquinolone group (77 hospitalizations), without differences among ciprofloxacin and levofloxacin. A higher incidence of antibiotic-related neurological events was reported in fluoroquinolone-treated patients hospitalized for recurrences of COPD exacerbations. These patients require special attention because of the risk of disease and treatment-induced neuropsychiatric disturbances. RezumatExistă dovezi că pacienții care au primit fluorochinolone (levofloxacină sau ciprofloxacină) sau ceftriaxonă au un risc mai mare de evenimente adverse neuropsihiatrice. Cercetarea noastră a evaluat rata evenimentelor adverse neuropsihiatrice induse de antibioticele administrate în timpul spitalizărilor, la pacienții internați pentru exacerbări ale bolii pulmonare obstructive cronice (BPOC). S-a efectuat un studiu retrospectiv, transversal, monocentric, în Spitalul de Boli Pulmonare, incluzând spitalizări pentru exacerbări ale BPOC din iunie 2014 până în mai 2019. Criterii de includere: > 40 de ani, > 2 spitalizări pentru un pacient în decurs de un an cu cel puțin o reinternare precoce < 30 zile și tratament cu cel puțin un antibiotic > 24 ore. Au fost excluși pacienții cu BPOC în stadiu terminal, astm, tuberculoză, cancer, boli neurologice sau psihiatrice cunoscute. Spitalizările au fost împărțite în funcție de tratament : fluorochinolone și non-fluorochinolone. Tratamentul non-fluorochinolonic a fost predominant (72,21% dintre spitalizări). Evenimentele neuropsihiatrice au fost semnificativ mai frecvente în grupul fluorochinolonelor (77 spitalizări), fără diferențe între ciprofloxacină și levofloxacină. O incidență mai mare a evenimentelor neurologice induse de antibiotice a fost observată la pacienții tratați cu fluorochinolone spitalizați pentru recurențe ale exacerbărilor BPOC. Acești pacienți necesită o atenție specială din cauza riscului de tulburări neuropsihiatrice induse de boală și tratament.

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Section: Manifestationsmentioning

confidence: 99%

Antibiotic-Related Adverse Events in Hospitalized Chronic Obstructive Pulmonary Disease Patients With Frequent Exacerbation: A Retrospective Study

CRETU

2023

FARMACIA

View full text Add to dashboard Cite

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“…Nevertheless, there are several reports of mania associated with quinolones, specifically with ciprofloxacin, ofloxacin, and norfloxacin (Table 1). [22][23][24][25][26][27] There is a substantial overlap in symptoms of delirium, acute psychosis, and mania associated with quinolones, and in all these conditions, there is a rapid recovery with medication discontinuation, thus raising the possibility that they lie in a continuum. However, most of the case reports of drug-associated acute psychosis and mania have been differentiated from delirium or encephalopathy based on the absence of confusion and disorientation.…”

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confidence: 99%

“…29 In most cases, manic reactions are idiosyncratic, unless there is a predisposition (eg, genetic or personality factors) or previous diagnosis of bipolar disorder. [22][23][24][25][26][27] Levofloxacin has the lowest CNS penetration; hence, reported neuropsychiatric adverse reactions are uncommon. 2 Although infrequent, neuropsychiatric reactions associated with levofloxacin may involve mania, in addition to delirium and psychosis.…”

mentioning

confidence: 99%

“…Nevertheless, there are several reports of mania associated with quinolones, specifically with ciprofloxacin, ofloxacin, and norfloxacin (Table 1). 22–27…”

mentioning

confidence: 99%

“…29 In most cases, manic reactions are idiosyncratic, unless there is a predisposition (eg, genetic or personality factors) or previous diagnosis of bipolar disorder. 22–27 Levofloxacin has the lowest CNS penetration; hence, reported neuropsychiatric adverse reactions are uncommon. 2…”

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