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Drug Safety

, Volume 34, Issue 6, pp 465–488 | Cite as

Quinolones

Review of Psychiatric and Neurological Adverse Reactions
  • Ana Maria ToméEmail author
  • Augusto Filipe
Review Article

Abstract

Quinolones are a class of antibacterial agents for the treatment of several infectious diseases (e.g. urinary and respiratory tract infections). They are used worldwide due to their broad spectrum of activity, high bioavailability and good safety profile. The safety profile varies from quinolone to quinolone.

The aim of this article was to review the neurological and psychiatric adverse drug reaction (ADR) profile of quinolones, using a literature search strategy designed to identify case reports and case series. A literature search using PubMed/MEDLINE (from inception to 31 October 2010) was performed to identify case reports and case series related to quinolone-associated neurological and psychiatric ADRs. The search was conducted in two phases: the first phase was the literature search and in the second phase relevant articles were identified through review of the references of the selected articles. Relevant articles were defined as articles referring to adverse events/ reactions associated with the use of any quinolone. Abstracts referring to animal studies, clinical trials and observational studies were excluded. Identified case reports were analysed by age group, sex, active substances, dosage, concomitant medication, ambulatory or hospital-based event and seriousness, after Medical Dictionary for Regulatory Activities (MedDRA®) coding.

From a total of 828 articles, 83 were identified as referring to nervous system and/or psychiatric disorders induced by quinolones. 145 individual case reports were extracted from the 83 articles. 40.7% of the individual case reports belonged to psychiatric disorders only, whereas 46.9% related to neurological disorders only. Eight (5.5%) individual case reports presented both neurological and psychiatric ADRs. Ciprofloxacin, ofloxacin and pefloxacin were the quinolones with more neurological and psychiatric ADRs reported in the literature. Ciprofloxacin has been extensively used worldwide, which may explain the higher number of reports, while for ofloxacin and pefloxacin, the number of reports may be over-representative. A total of 232 ADRs were identified from the selected articles, with 206 of these related to psychiatric and/or neurological ADRs. The other 26 were related to other body systems but were reported together with the reactions of interest. Mania, insomnia, acute psychosis and delirium were the most frequently reported psychiatric adverse events; grand mal convulsion, confusional state, convulsions and myoclonus were the most frequently reported neurological adverse events.

Several aspects should be taken into account in the development of CNS adverse effects, such as the pharmacokinetics of quinolones, chemical structure and quinolone uptake in the brain. These events may affect not only susceptible patients but also ’healthy’ patients.

Keywords

Ofloxacin Quinolones Gatifloxacin Pefloxacin Enoxacin 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

The authors would like to thank Liliana Coelho, assistant at the Medical Department, Grupo Tecnimede, for her support and assistance with retrieving full-text articles. Both authors are full-time employees of Grupo Tecnimede, which markets some fluoroquinolones (ciprofloxacin, levofloxacin, lomefloxacin and ofloxacin) in some European and non-European countries. No sources of funding were used to assist in the preparation of this review.

References

  1. 1.
    Mehlhorn AJ, Brown DA. Safety concerns with fluoroquinolones. Ann Pharmacother 2007; 41: 1859–66PubMedCrossRefGoogle Scholar
  2. 2.
    Zhanel GH, Noreddin AM. Pharmacokinetics and pharmaco-dynamics of the new fluoroquinolones: focus on respiratory infections. Curr Opin Pharmacol 2001; 1(5): 459–63PubMedCrossRefGoogle Scholar
  3. 3.
    Blondeau JM. Fluoroquinolones: mechanism of action, classification, and development of resistance. Surv Oph-thalmol 2004; 49 Suppl. 2: S73–8CrossRefGoogle Scholar
  4. 4.
    Melhus A. Fluoroquinolones and tendon disorders. Expert Opin Drug Saf 2005; 4(2): 299–309PubMedCrossRefGoogle Scholar
  5. 5.
    Lewis RJ, Mohr III JF. Dysglycaemias and fluoroquinolones. Drug Saf 2008; 31(4): 283–92PubMedCrossRefGoogle Scholar
  6. 6.
    Dukes MNG, editor. Meyler’s side effects of drugs: the international encyclopedia of adverse drug reactions and interactions: fluoroquinolones. 15th ed. Amsterdam: Elsevier Science, 2006: 1396–407Google Scholar
  7. 7.
    Sprandel KA, Rodvold KA. Safety and tolerability of fluoroquinolones. Clin Cornerstone 2003; 5 Suppl. 3: S29–36CrossRefGoogle Scholar
  8. 8.
    Smith DA, Schmid EF. Drugs withdrawals and the lessons within. Curr Opin Drug Discov Devel 2006; 9(1): 38–46PubMedGoogle Scholar
  9. 9.
    Rubinstein E. History of quinolones and their side effects. Chemotherapy 2001; 47 Suppl. 3: 3–8PubMedCrossRefGoogle Scholar
  10. 10.
    European Medicines Agency. EMEA restricts use of oral norfloxacin drugs in UTIs. London: European Medicines Agency, 2008 Jul 24Google Scholar
  11. 11.
    European Medicines Agency (EMEA), Danish Medicines Agency. EMEA recommends restricting the use of oral moxifloxacin-containing medicines. London: European Medicines Agency, 2008 Jul 24Google Scholar
  12. 12.
    Owens Jr RC, Ambrose PG. Antimicrobial safety: focus on fluoroquinolones. Clin Infect Dis 2005; 41 Suppl. 2: S144–57PubMedCrossRefGoogle Scholar
  13. 13.
    Fish DN. Fluoroquinolone adverse effects and drug interactions. Pharmacotherapy 2001; 21 (10 Pt 2): 253–72SCrossRefGoogle Scholar
  14. 14.
    Sweetman SC, editor. Martindale: the complete drug reference. 33rd ed. London: Pharmaceutical Press; 2002: 113, 182–6, 201, 209, 219–20, 232; 248, 266–7Google Scholar
  15. 15.
    Ball P. Adverse drug reactions: implications for the development of fluoroquinolones. J Antimicrob Chemother 2003; 51 Suppl. 1: 21–7PubMedCrossRefGoogle Scholar
  16. 16.
    Rodvold KA, Neuhauser M. Pharmacokinetics and pharm-acodynamics of fluoroquinolones. Pharmacotherapy 2001; 21 (10 Pt 2): 233–52SCrossRefGoogle Scholar
  17. 17.
    Perry CM, Barman Balfour JA, Lamb HM. Gatifloxacin. Drugs 1999 Oct; 58(4): 683–96; discussion 697–8PubMedCrossRefGoogle Scholar
  18. 18.
    Jo M, Tachi N, Shinoda M. Convulsions from excessive dosage of nalidixic acid: a case report. Brain Dev 1979; 1: 327–9PubMedCrossRefGoogle Scholar
  19. 19.
    Koppel C, Hopfe T, Menzel J. Central anticholinergic syndrome after ofloxacin overdose and therapeutic doses of diphenhydramine and chlormezanone. J Toxicol Clin Toxicol 1990; 28: 249–53PubMedCrossRefGoogle Scholar
  20. 20.
    Bagon JA. Neuropsychiatric complications following quinolone overdose in renal failure [letter]. Nephrol Dial Transpl 1999; 14: 1337CrossRefGoogle Scholar
  21. 21.
    Tattevin P, Messiaen T, Pras V, et al. Confusion and general seizures following ciprofloxacin administration. Nephrol Dial Transplant 1998; 13: 2712–3PubMedCrossRefGoogle Scholar
  22. 22.
    Aoun M, Jacquy C, Debusscher L, et al. Peripheral neuropathy associated with fluoroquinolones [letter]. Lancet 1992; 340: 127PubMedCrossRefGoogle Scholar
  23. 23.
    Orón JD, Ivorra J, Portilla J, et al. Reacción psicótica tras la administración de indometacina y ciprofloxacino [letter]. Rev Clin Esp 1992; 191: 401PubMedGoogle Scholar
  24. 24.
    Altés J, Gascó J, Antonio J, et al. Ciprofloxacin and delirium. Ann Intern Med 1989; 110: 170–1PubMedGoogle Scholar
  25. 25.
    McDermott JL, Gideonse N, Campbell JW. Acute delirium associated with ciprofloxacin administration in a hospitalized elderly patient. J Am Geriatr Soc 1991; 39: 909–10PubMedGoogle Scholar
  26. 26.
    Kiangkitiwan B. Levofloxacin-induced delirium with psychotic features. Gen Hosp Psychiatry 2008; 30(4): 381–3PubMedCrossRefGoogle Scholar
  27. 27.
    Reeves RR. Ciprofloxacin-induced psychosis. Ann Pharmacother 1992; 26: 930–1PubMedGoogle Scholar
  28. 28.
    Meher LK, Tripathy D, Acharya S. Ciprofloxacin induced psychosis. J Assoc Physicians India 1992; 40: 418–9PubMedGoogle Scholar
  29. 29.
    Mulhall JP, Bergmann LS. Ciprofloxacin-induced acute psychosis. Urology 1995; 46(1): 102–3PubMedCrossRefGoogle Scholar
  30. 30.
    Zaudig M, von Bose M, Weber MM, et al. Psychotoxic effects of ofloxacin. Pharmacopsychiatry 1989; 22: 11–5PubMedCrossRefGoogle Scholar
  31. 31.
    James E, Demian A. Acute psychosis in a trauma patient due to ciprofloxacin. Postgrad Med J 1998; 74: 189–90PubMedCrossRefGoogle Scholar
  32. 32.
    Hakko E, Mete B, Ozaras R, et al. Levofloxacin-induced delirium [letter]. Clin Neurol Neurosurg 2005; 107(2): 158–9PubMedCrossRefGoogle Scholar
  33. 33.
    Andrejak M, Schmit JL, Tondriaux A, et al. Neurological side effects of fluoroquinolones: apropos of 9 cases concerning pefloxacin [in French]. Therapie 1992; 47(5): 415–8PubMedGoogle Scholar
  34. 34.
    Asensio-Sánchez VM, Rodríguez-Delgado B, García-Herrero E, et al. Visual hallucinations secondary to ciprofloxacin treatment. Arch Soc Esp Oftalmol 2007; 82(5): 299–301PubMedCrossRefGoogle Scholar
  35. 35.
    Melvani S, Speed BR. Alatrofloxacin-induced seizures during slow intravenous infusion. Ann Pharmacother 2000; 34: 1017–9PubMedCrossRefGoogle Scholar
  36. 36.
    Quigley CA, Lederman JR. Possible gatifloxacin-induced seizure. Ann Pharmacother 2004; 38: 235–7PubMedCrossRefGoogle Scholar
  37. 37.
    Isaacson SH, Carr J, Rowan AJ. Ciprofloxacin-induced complex partial status epilepticus manifesting as an acute confusional state. Neurology 1993; 43: 1619–21PubMedCrossRefGoogle Scholar
  38. 38.
    Wimer SM, Schoonover L, Garrison MW. Levofloxacin: a therapeutic review. Clin Ther 1998; 20(6): 1049–70PubMedCrossRefGoogle Scholar
  39. 39.
    Balfour JA, Wiseman LR. Moxifloxacin. Drugs 1999 Mar; 57(3): 363–73; discussion 374PubMedCrossRefGoogle Scholar
  40. 40.
    De Sarro A, De Sarro G. Adverse reactions to fluoro-quinolones: an overview on mechanistic aspects. Curr Med Chem 2001; 8(4): 371–84PubMedCrossRefGoogle Scholar
  41. 41.
    Kushner JM, Peckman HJ, Snyder CR. Seizures associated with fluoroquinolones. Ann Pharmacother 2001; 35(10): 1194–8PubMedCrossRefGoogle Scholar
  42. 42.
    Oliphant CM, Green GM. Quinolones: a comprehensive review. Am Fam Physician 2002; 65(3): 455–64PubMedGoogle Scholar
  43. 43.
    Turnidge J. Pharmacokinetics and pharmacodynamics of fluoroquinolones. Drugs 1999; 58 Suppl. 2: 29–36PubMedCrossRefGoogle Scholar
  44. 44.
    Tamai I, Yamashita J, Kido Y, et al. Limited distribution of new quinolone antibacterial agents into brain caused by multiple efflux transporters at the blood-brain barrier. J Pharmacol Exp Ther 2000; 295(1): 146–52PubMedGoogle Scholar
  45. 45.
    Mandell L, Tillotson G. Safety of fluoroquinolones: an update. Can J Infect Dis 2002; 13(1): 54–61PubMedGoogle Scholar
  46. 46.
    Case report [online]. Available from URL: http://en.wikipedia.org/wiki/Case_report [Accessed 2010 Sep 8]
  47. 47.
    ICH E2E: pharmacovigilance planning. CPMP/ICH/ 5716/03 [online]. Available from URL: http://www.ich.org/products/guidelines/efficacy/article/efficacy-guidelines.html [Accessed 2010 Sep 8]
  48. 48.
    Kelly WN, Arellano FM, Barnes J, et al. Guidelines for submitting adverse event reports for publication. Drug Saf 2007;30(5): 367–73PubMedCrossRefGoogle Scholar
  49. 49.
    Tripathi A, Chen SI, O’Sullivan S. Acute psychosis following the use of topical ciprofloxacin. Arch Ophthalmol 2002; 120: 665–6PubMedGoogle Scholar
  50. 50.
    Orr CF, Rowe DB. Eardrops attacks: seizures triggered by ciprofloxacin eardrops. Med J Aust 2003; 178: 343PubMedGoogle Scholar
  51. 51.
    Islam MA, Sreedharan T. Convulsions, hyperglycemia and glycosuria from overdose of nalidixic acid. JAMA 1965; 192: 1100–1PubMedCrossRefGoogle Scholar
  52. 52.
    Schwartz MT, Calvert JF. Potential neurological toxicity related to ciprofloxacin. DICP 1990; 24(2): 138–40PubMedGoogle Scholar
  53. 53.
    Kim SH, Jeong SH, Kim JW, et al. A case of hemiballism as a rare side effect of ciprofloxacin in a patient with liver cirrhosis. Chemotherapy 2009; 55: 207–10PubMedCrossRefGoogle Scholar
  54. 54.
    Holden R. Probable fatal interaction between ciprofloxacin and theophylline [letter]. BMJ 1988; 297: 1339PubMedCrossRefGoogle Scholar
  55. 55.
    Spivey JM, Laughlin PH, Goss TF, et al. Theophylline toxicity secondary to ciprofloxacin administration. Ann Emerg Med 1991; 20: 1131–4PubMedCrossRefGoogle Scholar
  56. 56.
    Herrlin K, Segerdahl M, Gustafsson LL, et al. Methadone, ciprofloxacin, and adverse drug reactions. Lancet 2000; 356: 2069–70PubMedCrossRefGoogle Scholar
  57. 57.
    Fan-Havard P, Sanchorawala V, Oh J, et al. Concurrent use of foscarnet and ciprofloxacin may increase the propensity for seizures. Ann Pharmacother 1994; 28: 869–72Google Scholar
  58. 58.
    Rollof J, Vinge E. Neurological adverse effects during concomitant treatment with ciprofloxacin, NSAIDs, and chloroquine: possible drug interaction. Ann Pharmacother 1993; 27: 1058–9PubMedGoogle Scholar
  59. 59.
    Lee J, Franz L, Goforth HW. Serotonin syndrome in a chronic-pain patient receiving concurrent methadone, ciprofloxacin, and venlafaxine [letter]. Psychosomatics 2009; 50(6): 638–9PubMedGoogle Scholar
  60. 60.
    Sharma DD, Aggarwal A, Sharma RC, et al. A probable association of acute dystonia with gemifloxacin administration. Indian J Med Sci 2009; 63(12): 557–60PubMedCrossRefGoogle Scholar
  61. 61.
    Christie MJ, Wong K, Ting RH, et al. Generalized seizure and toxic epidermal necrolysis following levofloxacin exposure. Ann Pharmacother 2005; 39(5): 953–5PubMedCrossRefGoogle Scholar
  62. 62.
    Simpson KJ, Brodie JR. Convulsions related to enoxacin [letter]. Lancet 1985; II: 161CrossRefGoogle Scholar
  63. 63.
    Poe TE, Marion GS, Jackson DS. Seizures due to nalidixic acid therapy. South Med J 1984; 77: 539–40PubMedCrossRefGoogle Scholar
  64. 64.
    Anastasio GD, Menscer D, Little JM. Norfloxacin and seizures [letter]. Ann Intern Med 1988; 109: 169–70PubMedGoogle Scholar
  65. 65.
    Traeger SM, Nonfiglio MF, Wilson JA, et al. Seizures associated with ofloxacin therapy. Clin Infect Dis 1995; 21(6): 1504–6PubMedCrossRefGoogle Scholar
  66. 66.
    Montané E, Barriocanal A, Isern I, et al. Multiple drug interactions–induced serotonin syndrome: a case report. J Clin Pharm Ther 2009; 34: 485–7PubMedCrossRefGoogle Scholar
  67. 67.
    Conri C, Lartigue MC, Abs L, et al. Convulsions chez une malade traitée par péfloxacine et théophylline [letter]. Thérapie 1990; 45: 358PubMedGoogle Scholar
  68. 68.
    Bader MB. Role of ciprofloxacin in fatal seizures. Chest 1992; 101: 883–4PubMedCrossRefGoogle Scholar
  69. 69.
    Romano C, Cristina T, Daniela C, et al. Epileptic attacks associated with pefloxacin treatment in a patient on CAPD [letter]. Clin Nephrol 1989; 32: 48–9PubMedGoogle Scholar
  70. 70.
    Bercault N, DeMasure M, Benhamou CL, et al. Seizures in the course of prolonged treatment with ofloxacin. Rev Med Interne 1993; 14: 194PubMedCrossRefGoogle Scholar
  71. 71.
    Slavich IL, Gleffe RF, Haas EJ. Grand mal epileptic seizures during ciprofloxacin therapy. JAMA 1989; 261: 558–9PubMedCrossRefGoogle Scholar
  72. 72.
    Karki SD, Bentley DW, Raghavan M. Seizure with ciprofloxacin and theophylline combined therapy. DICP 1990; 24(6): 595–6PubMedGoogle Scholar
  73. 73.
    Semel JD, Allen N. Seizures in patients simultaneously receiving theophylline and imipenem or ciprofloxacin or metronidazole. South Med J 1991; 84: 465–8PubMedCrossRefGoogle Scholar
  74. 74.
    Abouesh A, Stone C, Hobbs WR. Antimicrobial-induced mania (antibiomania): a review of spontaneous reports. J Clin Psychopharmacol 2002; 22: 71–81PubMedCrossRefGoogle Scholar
  75. 75.
    Lucet JC, Tilly J, Lerebours G, et al. Neurological toxicity related to pefloxacin [letter]. J Antimicrob Chemother 1988; 21: 811–2PubMedCrossRefGoogle Scholar
  76. 76.
    Walton GD, Hon JK, Mulpur TG. Ofloxacin-induced seizures. Ann Pharmacother 1997; 31(12): 1475–7PubMedGoogle Scholar
  77. 77.
    Jeandel C, Laurain MC, Jouanny P, et al. État de mal épileptique sous ofloxacine. Rev Med Interne 1994; 15: 218–9PubMedCrossRefGoogle Scholar
  78. 78.
    Leone R, Venegoni M, Motola D, et al. Adverse drug reactions related to the use of fluoroquinolone anti-microbials: an analysis of spontaneous reports and fluor-oquinolone consumption data from three Italian regions. Drug Saf 2003; 26(2): 109–20PubMedCrossRefGoogle Scholar
  79. 79.
    Halliwell RF, Su J, Demuro A, et al. Characterization of the interaction between a novel convulsant agent, norbiphen, and GABAA and other ligand-gated ion channels. Neuropharmacology 2002; 43: 778–87PubMedCrossRefGoogle Scholar
  80. 80.
    Shimada J, Hori S. Adverse effects of fluoroquinolones. Prog Drug Res 1992; 38: 133–43PubMedGoogle Scholar
  81. 81.
    Kim J, Ohtani H, Tsujimoto M, et al. Quantitative comparison of the convulsive activity of combinations of twelve fluoroquinolones with five nonsteroidal anti-inflammatory agents. Drug Metab Pharmacokinet 2009; 24(2): 167–74PubMedCrossRefGoogle Scholar
  82. 82.
    Marinella MA. Myoclonus and generalized seizures associated with gatifloxacin treatment. Arch Intern Med 2001; 161: 2261–2PubMedCrossRefGoogle Scholar
  83. 83.
    Stahlmann R, Lode H. Fluoroquinolones in the elderly: safety considerations. Drugs Aging 2003; 20(4): 289–302PubMedCrossRefGoogle Scholar
  84. 84.
    Lahmek P, Michel L, Meunier N, et al. A seizure attributed to ofloxacine in a woman undergoing detoxification for alcohol dependence. Case Report Med. Epub 2010 Jan 24Google Scholar
  85. 85.
    Agbaht K, Bitik B, Piskinpasa S, et al. Ciprofloxacin-associated seizures in a patient with underlying thyrotoxicosis: case report and literature review. Int J Clin Pharmacol Ther 2009; 47(5): 303–10PubMedGoogle Scholar
  86. 86.
    Hall CE, Keegan H, Rogstad KE. Psychiatric side effects of ofloxacin used in the treatment of pelvic inflammatory disease. Int J STD AIDS 2003; 14(9): 636–7PubMedCrossRefGoogle Scholar
  87. 87.
    McCue JD, Zandt JR. Acute psychoses associated with the use of ciprofloxacin and trimethoprim-sulfamethoxazole. Am J Med 1991; 90(4): 528–9PubMedCrossRefGoogle Scholar
  88. 88.
    Grimm O, Alm B, Fur Seelische Z. A case of ciprofloxacin-induced acute polymorphic psychosis with a distinct deficit in executive functions [letter]. Psychosomatics 2007; 48(3): 269PubMedCrossRefGoogle Scholar
  89. 89.
    Norra C, Skobel E, Breuer C, et al. Ciprofloxacin-induced acute psychosis in a patient with multidrug-resistant tuberculosis. Eur Psychiatry 2003; 18(5): 262–3PubMedCrossRefGoogle Scholar
  90. 90.
    Farrington J, Stoudemire A, Tierney J. The role of ciprofloxacin in a patient with delirium due to multiple etiologies. Gen Hosp Psychiatry 1995; 17: 47–53PubMedCrossRefGoogle Scholar
  91. 91.
    Fennig S, Mauas L. Ofloxacin-induced delirium [letter]. J Clin Psychiatry 1992; 53(4): 137–8PubMedGoogle Scholar
  92. 92.
    Ahuja N, Lloyd AJ. Antibiomania and ciprofloxacin-induced mania [letter]. Psychosomatics 2007; 48(4): 36CrossRefGoogle Scholar
  93. 93.
    de Bazignan AD, Thiessard F, Miremont-Salamé G, et al. Psychiatric adverse effects of fluoroquinolones: review of cases from the French pharmacologic surveillance database. Rev Med Interne 2006; 27(6): 448–52CrossRefGoogle Scholar
  94. 94.
    Steinert T, Studemund H. Acute delusional parasitosis under treatment with ciprofloxacin. Pharmacopsychiatry 2006; 39(4): 159–60PubMedCrossRefGoogle Scholar
  95. 95.
    Cheung YF, Wong WW, Tang KW, et al. Ciprofloxacin-induced palatal tremor. Mov Disord 2007; 22(7): 1038–43PubMedCrossRefGoogle Scholar
  96. 96.
    Lee CH, Cheung RTF, Chan TM. Ciprofloxacin-induced oral facial dyskinesia in a patient with normal liver and renal function. Hosp Med 2000; 61: 142–3PubMedGoogle Scholar
  97. 97.
    Azar S, Ramjiani A, Van Gerpen JA. Ciprofloxacin-induced chorea. Mov Disord 2005; 20: 513–4PubMedCrossRefGoogle Scholar
  98. 98.
    Pastor P, Moitinho E, Elizalde I, et al. Reversible oral-facial dyskinesia in a patient receiving ciprofloxacin hydrochloride. J Neurol 1996; 243: 616–7PubMedCrossRefGoogle Scholar
  99. 99.
    MacLeod W. Case report: severe neurological reaction to ciprofloxacin. Can Fam Physician 2001; 47: 553–5PubMedGoogle Scholar
  100. 100.
    Thomas RJ, Reagan DR. Association of a Tourette-like syndrome with ofloxacin. Ann Pharmacother 1996; 30: 138–41PubMedGoogle Scholar
  101. 101.
    Post B, Koelman JHTM, Tijssen MAJ. Propriospinal myoclonus after treatment with ciprofloxacin. Mov Disord 2004; 19: 595–7PubMedCrossRefGoogle Scholar
  102. 102.
    Mohan N, Menon K, Rao PG. Oral gatifloxacin-induced ataxia [letter]. Am J Health Syst Pharm 2002; 59(19): 1894PubMedGoogle Scholar
  103. 103.
    Rosolen A, Drigo P, Zanesco L. Acute hemiparesis associated with ciprofloxacin [letter]. BMJ 1994; 309: 1411PubMedCrossRefGoogle Scholar
  104. 104.
    Upton C. Sleep disturbance in children treated with ofloxacin [letter]. BMJ 1994; 309: 141CrossRefGoogle Scholar
  105. 105.
    Akhtar S, Ahmad H. Ciprofloxacin-induced catatonia [letter]. J Clin Psychiatry 1993; 54: 115–6PubMedGoogle Scholar
  106. 106.
    Youssef NA, Benazzi F, Desan PH. Levofloxacin-induced catatonia. Prog Neuropsychopharmacol Biol Psychiatry 2009; 33(4): 741–2PubMedCrossRefGoogle Scholar
  107. 107.
    Rauser EH, Ariano ER, Anderson AD. Exacerbation of myasthenia gravis by norfloxacin. DCIP Ann Pharmacother 1990; 240: 207–8Google Scholar
  108. 108.
    Mumford CJ, Ginsberg L. Ciprofloxacin and myasthenia gravis [letter]. BMJ 1990; 301: 818PubMedCrossRefGoogle Scholar
  109. 109.
    Fraser AG, Harrower ADB. Convulsions and hypergly-caemia associated with nalidixic acid [letter]. BMJ 1977; 2(6101): 1578CrossRefGoogle Scholar
  110. 110.
    Striano P, Zara F, Coppola A, et al. Epileptic myoclonus as ciprofloxacin-associated adverse effect. Mov Disord 2007; 22(11): 1675–6PubMedCrossRefGoogle Scholar
  111. 111.
    Bellon A, Perez-Garcia G, Coverdale JH, et al. Seizures associated with levofloxacin: case presentation and literature review. Eur J Clin Pharmacol 2009; 65(10): 959–62PubMedCrossRefGoogle Scholar
  112. 112.
    Kisa C, Yildirim SG, Aydemir C, et al. Prolonged electro-convulsive therapy seizure in a patient taking ciprofloxacin. J ECT 2005; 21(1): 43–4PubMedCrossRefGoogle Scholar
  113. 113.
    LaSalvia EA, Domek GJ, Gitlin DF. Fluoroquinolone-induced suicidal ideation. Gen Hosp Psychiatry 2010 Jan–Feb; 32(1): 108–10PubMedCrossRefGoogle Scholar
  114. 114.
    Sire S, Staub-Schmidt T, Ragnaud JM, et al. À prpos d’une crise comitiale sous ofloxacine. Rev Med Interne 1996; 17: 601–2PubMedCrossRefGoogle Scholar
  115. 115.
    Barrett MJ, Login IS. Gemifloxacin-associated neurotoxicity presenting as encephalopathy. Ann Pharmacother 2009; 43(4): 782–4PubMedCrossRefGoogle Scholar
  116. 116.
    Heyd A, Haverstock D. Retrospective analysis of the safety profile of oral and intravenous ciprofloxacin in a geriatric population. Clin Ther 2000; 22(10): 1239–50PubMedCrossRefGoogle Scholar
  117. 117.
    Bertino Jr J, Fish D. The safety profile of the fluoroquinolones. Clin Ther 2000; 22(7): 798–817PubMedCrossRefGoogle Scholar
  118. 118.
    Stahlmann R, Lode H. Toxicity of quinolones. Drugs 1999; 58 Suppl. 2: 37–42PubMedCrossRefGoogle Scholar
  119. 119.
    Cipro®: summary of product characteristics. Wayne (NJ): Bayer Healthcare Pharmaceuticals Inc., 2009Google Scholar
  120. 120.
    Tavanic® 500mg tablets: summary of product characteristics. Guildford: Sanofi-Aventis, 2009Google Scholar
  121. 121.
    Seizure: causes [online]. Available from URL: http://en.wikipedia.org/wiki/Seizure#Causes [Accessed 2010 Feb 15]
  122. 122.
    Akaike N, Shirasaki T, Yakushiji T. Quinolone and fenbufen interact with GABA(A) receptor in dissociated hippo-campal cells of rat. J Neuropsychol 1991; 66(2): 497–504Google Scholar
  123. 123.
    Wilton LV, Pearce GL, Mann RD. A comparison of ciprofloxacin, norfloxacin, ofloxacin, azithromycin and cefixime examined by observational cohort studies. Br J Clin Pharmacol 1996; 41(4): 277–84PubMedCrossRefGoogle Scholar
  124. 124.
    Sweweb [online]. Available from: URL: http://sweweb.mpa.se/swedisii/ [Accessed 2010 Feb 15]
  125. 125.
    Utinor® tablets 400 mg: summary of product characteristics. Whitehouse Station (NJ): Merck Sharp & Dohme Limited, 2009Google Scholar
  126. 126.
    Tarivid® 200 mg and 400 mg tablets: summary of product characteristics. Guildford: Sanofi-Aventis, 2009Google Scholar
  127. 127.
    US FDA. Risk of fluoroquinolone-associated myasthenia gravis exacerbation February 2011 label changes for fluoroquinolones [online]. Available from URL: http://www.fda.gov/Safety/MedWatch/SafetyInformation/ucm247115.htm2011 [Accessed 2011 Apr 18]

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© Adis Data Information BV 2011

Authors and Affiliations

  1. 1.Medical DepartmentGrupo Tecnimede, Zona Industrial da AbrunheiraSintraPortugal

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