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Shamik Bhattacharyya (Brigham and Women's) led a
study reviewing case reports from the past seven
decades on patients who developed delirium and
related conditions after taking antibiotics.The
scientists found that nearly half suffered delusions
or hallucinations.
Delirium is a common and costly complication of
hospitalization. Although medications are a known
cause of delirium, antibiotics are an
underrecognized class of medications associated with
delirium. Delirium, mental confusion that may be
paired with hallucinations and agitation is a common
and costly complication of hospitalization and is
often caused by medications.
According to new research, scientists
comprehensively review the clinical, radiologic, and
electrophysiologic features of antibiotic-associated
encephalopathy (AAE).
AAE can be divided into 3 unique clinical
phenotypes:
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encephalopathy commonly accompanied by seizures
or myoclonus arising within days after
antibiotic administration (caused by
cephalosporins and penicillin);
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encephalopathy characterized by psychosis
arising within days of antibiotic administration
(caused by quinolones, macrolides, and procaine
penicillin);
-
encephalopathy accompanied by cerebellar signs
and MRI abnormalities emerging weeks after
initiation of antibiotics (caused by
metronidazole).
Reserchers correlate these 3 clinical phenotypes
with underlying pathophysiologic mechanisms of
antibiotic neurotoxicity. Familiarity with these
types of antibiotic toxicity can improve timely
diagnosis of AAE and prompt antibiotic
discontinuation, reducing the time patients spend in
the delirious state.
Reviewing case reports on patients given antibiotics
who later developed delirium and related issues, the
scientists found that nearly half suffered delusions
or hallucinations. Seven out of 10 were found to
have abnormal electrical activity in the brain.
For
more information
Antibiotic-associated encephalopathy
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