Antibiotics May Cause Delirium

Antibiotics can cause neurological issues, such as delirium and psychosis, within days or weeks of use, according to new research.

Previous studies have suggested that certain medications lead to cognitive impairment and other neurological issues, but the extent to which antibiotics cause delirium is underrecognized, especially when elderly patients are already susceptible to developing dementia.
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To conduct their study, researchers analyzed data from the prior 70 years of 391 patients who had taken antibiotics and later developed delirium or other neurological issues.

Researchers assessed 54 antibiotics from 12 classes that included intravenous and common medications, such as penicillin, cephalosporins, and sulfonamides.

Researchers classified encephalopathy patients into 3 phenotypes:

  • Associated with seizures or uncontrollable muscle spasms after a few days of antibiotic use,
  • Associated with psychosis after a few days of antibiotic use, and
  • Associated with irregular magnetic resonance imaging (MRI) and electroencephalogram (EEG) tests after weeks of antibiotic use.

After analyzing the data, researchers found that 47% of patients had hallucinations or delusions, 15% had muscle spasms, 14% had seizures, and 5% lost control over their movements. In addition, 70% had abnormal EEG tests.

“Familiarity with these types of antibiotic toxicity can improve timely diagnosis of  antibiotic-associated encephalopathy and prompt antibiotic discontinuation, reducing the time patients spend in the delirious state,” researchers concluded.

—Amanda Balbi

Reference:

Bhattacharyya S, Darby RR, Raibagkar P, Gonzalez Castro LN, and Berkowitz AL. Antibiotic-associated encephalopathy. Neurology. Published online before print February 17, 2016. doi:10.1212/WNL.0000000000002455.