Table E-5. Publications Regarding Fluoroquinlones and Seizures Or Status Epilepticus

1

Sutter et al.

Table e-5. Publications regarding fluoroquinlones and seizures or status epilepticus

Reference / Year / Design (AAN Class of evidence) / Number of patients / Dosage / Contributing factors other than antibiotics / Reported symptomatic seizure(s)
Ciprofloxacin
Slavich et al. 1 / 1989 / Case reports
(Class IV) / 3 patients / 0.5-1 g ciprofloxacin per day / 2 with seizure history and 1 with theophylline, and 1 with severe brain damage / Seizures
Karki et al. 2 / 1990 / Case report
(Class IV) / 1 patient / 1 g ciprofloxacin per day / Additional treatment with theophyllin / Seizure
Schwartz et al. 3 / 1990 / Case report
(Class IV) / 1 patient / 1 g ciprofloxacin per day / Renal insufficiency / Generalized seizure
Semel et al. 4 / 1991 / Case report
(Class IV) / 1 patient / 1 g ciprofloxacin per day / Additional treatment with theophyllin / Repetitive generalized seizures
Bader 5 / 1992 / Case report
(Class IV) / 1 patient / 1 g ciprofloxacin per day / Additional treatment with theophyllin / Seizures and SE
Isaacson et al. 6 / 1993 / Case report
(Class IV) / 1 patient / Dosage not provided / None / Complex partial SE
Kisa et al. 7 / 2005 / Case report
(Class IV) / 1 patient / 1 g ciprofloxacin per day / Mental disorder / Prolonged seizure after electroconvulsive therapy
Kushner et al. 8 / 2001 / Case report
(Class IV) / 1 patient / 0.8 g ciprofloxacin per day / Renal insufficiency / Repetitive seizures
Agbaht et al. 9 / 2009 / Case report
(Class IV) / 1 patient / 1 g ciprofloxacin per day / Renal insufficiency / Generalized tonic-clonic seizures
Norfloxacin
Basnyat et al. 10 / 1998 / Case report
(Class IV) / 1 patient / 0.8 g norfloxacin per day / Prior seizure / Repetitive seizure
Moxifloxacin
Reti et al. 11 / 2007 / Case report
(Class IV) / 1 patient / 0.4 g moxifloxacin per day / Mental disorder / Prolonged seizure after electroconvulsive therapy
Qiao et al. 12 / 2011 / Case report
(Class IV) / 1 patient / 0.4 g moxifloxacin per day / Chronic renal insufficiency / SE
Levofloxacin
Kushner et al. 8 / 2001 / Case reports
(Class IV) / 2 patients / 0.25-0.5 g levofloxacin per day / 1 with renal insufficiency / Repetitive seizures
Christie et al. 13 / 2005 / Case report
(Class IV) / 1 patient / 0.5 g levofloxacin per day / None / Seizure
Bird et al. 14 / 2005 / Case report
(Class IV) / 1 patient / 0.5 g levofloxacin per day / Known epilepsy, renal insufficieny, and dementia / Repetitive seizures
Mazzei et al. 15 / 2012 / Case report
(Class IV) / 1 patient / Dosage not provided / None / NCSE
Gatifloxacin
Quigley et al. 16 / 2004 / Case report
(Class IV) / 1 patient / 0.4 g gatifloxacin per day / Renal insufficiency / Repetitive seizures
Koussa et al. 17 / 2006 / Case report
(Class IV) / 1 patient / 0.4 g gatifloxacin per day / Prior seizure / Generalized tonic-clonic SE
Alatrofloxacin
Melvani et al. 18 / 2000 / Case report
(Class IV) / 1 patient / 0.3 g alatrofloxacin per day / Prior medication ciprofloxacin, ceftazidime and vancomycin in sepsis / Repetitive generalized seizures

AAN = American Academy of Neurology; SE = status epilepticus; NCSE = nonconvulsive status epilepticus

References

1.Slavich IL, Gleffe RF, Haas EJ. Grand mal epileptic seizures during ciprofloxacin therapy. JAMA 1989;261:558-559.

2.Karki SD, Bentley DW, Raghavan M. Seizure with ciprofloxacin and theophylline combined therapy. DICP 1990;24:595-596.

3.Schwartz MT, Calvert JF. Potential neurologic toxicity related to ciprofloxacin. DICP 1990;24:138-140.

4.Semel JD, Allen N. Seizures in patients simultaneously receiving theophylline and imipenem or ciprofloxacin or metronidazole. South Med J 1991;84:465-468.

5.Bader MB. Role of ciprofloxacin in fatal seizures. Chest 1992;101:883-884.

6.Isaacson SH, Carr J, Rowan AJ. Ciprofloxacin-induced complex partial status epilepticus manifesting as an acute confusional state. Neurology 1993;43:1619-1621.

7.Kisa C, Yildirim SG, Aydemir C, Cebeci S, Goka E. Prolonged electroconvulsive therapy seizure in a patient taking ciprofloxacin. J ECT 2005;21:43-44.

8.Kushner JM, Peckman HJ, Snyder CR. Seizures associated with fluoroquinolones. Ann Pharmacother 2001;35:1194-1198.

9.Agbaht K, Bitik B, Piskinpasa S, Bayraktar M, Topeli A. Ciprofloxacin-associated seizures in a patient with underlying thyrotoxicosis: case report and literature review. Int J Clin Pharmacol Ther 2009;47:303-310.

10.Basnyat B. Fatal grand mal seizure in a Dutch trekker. J Travel Med 1998;5:221-222.

11.Reti IM, Davydow DS. Electroconvulsive therapy and antibiotics: a case report. J ECT 2007;23:289-290.

12.Qiao L, Cui X, Li Y. Status epilepticus attributed to moxifloxacin in an adolescent patient with spina bifida occulta. Eur J Clin Pharmacol 2011;67:103-104.

13.Christie MJ, Wong K, Ting RH, Tam PY, Sikaneta TG. Generalized seizure and toxic epidermal necrolysis following levofloxacin exposure. Ann Pharmacother 2005;39:953-955.

14.Bird SB, Orr PG, Mazzola JL, Brush DE, Boyer EW. Levofloxacin-related seizure activity in a patient with Alzheimer's disease: assessment of potential risk factors. J Clin Psychopharmacol 2005;25:287-288.

15.Mazzei D, Accardo J, Ferrari A, Primavera A. Levofloxacin neurotoxicity and non-convulsive status epilepticus (NCSE): a case report. Clin Neurol Neurosurg 2012;114:1371-1373.

16.Quigley CA, Lederman JR. Possible gatifloxacin-induced seizure. Ann Pharmacother 2004;38:235-237.

17.Koussa SF, Chahine SL, Samaha EI, Riachi MA. Generalized status epilepticus possibly induced by gatifloxacin. Eur J Neurol 2006;13:671-672.

18.Melvani S, Speed BR. Alatrofloxacin-induced seizures during slow intravenous infusion. Ann Pharmacother 2000;34:1017-1019.