FLUOROQUINOLONE NEUROTOXICITY IN THE ELDERLY

Older patients are taking more and more antibiotics, including fluoroquinolones. Their toxic effects on thenervous system and the psyche are well known but not well described and explained. We sought todetermine the number and severity of adverse effects on the nervous system and psyche caused byfluoroquinolones in patients over 65 years of age. We analyzed fluoroquinolone reports submitted to theCanada Vigilance Adverse Reaction Online Database and the Australian Database of Adverse EventNotification. A systematic literature search was also conducted. Confusion and hallucinations were thepredominant symptoms caused primarily by ciprofloxacin. The review of the publications indicates anincreased incidence of adverse effects on the nervous system in the elderly. Treatment withfluoroquinolones in the elderly should be closely monitored due to the potential for neurotoxicitymanifesting as neurological and/or psychiatric symptoms and the risk of misdiagnosis.