[Acute delirium, probably precipitated by clarithromycin].
Clarithromycin is a relatively new antibiotic with many applications. Its frequent use explains why side-effects previously reported seldom now become clear. Two patients, a man aged 74 and a woman aged 56 years, developed delirium after treatment with clarithromycin as part of eradication treatment of Helicobacter pylori, presumably as a result of an ideosyncratic reaction to the clarithromycin. Preclinical and clinical investigations did not reveal side effects on the central nervous system. By now the appearance of a delirium presumably related to the use of clarithromycin has been described in several patients. Furthermore some patients had a positive rechallenge. Finally, 17 reports on psychiatric side effects, of which 7 were delirium, after the use of clarithromycin reached the Netherlands Pharmacovigilance Foundation (Lareb). This combination of facts makes a causal relationship probable.
Pijlman
A H
AH
Afd. Interne Geneeskunde, Diakonessenhuis, Bosboomstraat 1, 3582 KE Utrecht. apijlman@diakhuis.nl
Kuck
E M
EM
van Puijenbroek
E P
EP
Hoekstra
J B
JB
D000208:Acute Disease; D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data*; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D017291:Clarithromycin / Q000009:adverse effects*; D003693:Delirium / Q000139:chemically induced*; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands
D000900:Anti-Bacterial Agents; D017291:Clarithromycin
Acuut delier, waarschijnlijk uitgelokt door claritromycine.