FLUOROQUINOLONE NEUROTOXICITY IN THE ELDERLY

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