Delirium levofloxacin

Many other commonly used antibiotics can cause psychiatric symptoms, for example, clarithromycin (trade name, Biaxin)—which is frequently used to treat respiratory illness, ear infections, and skin infections—has been reported to cause mania in some patients. Metronidazole (trade name Flagyl), which is used to treat many types of infections—from parasites to vaginal infections and abscesses—has been reported to cause depression, agitation, confusion, hallucinations, and mania. Trimethoprim-sulfamethoxazole (trade names Bactrim and Septra)—which is used, for example, for bladder infections and sinus and ear infections—has been reported to cause delirium, psychosis, depression, and hallucinations in rare cases. The fluoroquinolone antibiotics—such as ciprofloxacin (trade name Cipro), levofloxacin (trade name Levaquin), ofloxacin (trade name Floxin), trovafloxacin (trade name Trovan), and others of this class—can cause psychiatric symptoms fairly often, including confusion, agitation, depression, insomnia, mania, paranoia, and psychosis. 

Interference with diagnostic tests A 96-year-old woman with delirium had a false-positive urine screen for opiates after starting levofloxacin [39" ]. An enzyme immunoassay technique (SYNCHRON) was used initially, but repeat testing of the urine and serum by mass spectroscopy was negative. Enzyme... 

Psychiatric An 83-year-old man developed delirium after taking levofloxacin for 3 days for a right lower lobe pneumonia [62 ]. The delirium resolved within 2 days of levofloxacin withdrawal. The authors proposed that the underlying mechanism may be an agonist action at GABA receptors. 

Slobodin G, Elias N, Zaygraikin N, Sheikh-Ahmad M, Sabetay S, Weller B, Odeh M. Levofloxacin-induced delirium. Neurol Sci 2009 30(2) 159-61. 

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