Delirium in the elderly resulting from azithromycin therapy.
BACKGROUND
Azithromycin, a semi-synthetic azalide antibiotic, is a macrolide that thus far has not shared the neuropsychiatric side effects of other macrolides such as erythromycin and clarithromycin.


METHODS
We now report significant delirium associated with conventional dosing of azithromycin in two geriatric patients who were being treated for lower respiratory tract infection.


RESULTS
The onset of delirium was apparent within 72 hours of initiating azithromycin therapy and lasted 48 to 72 hours after discontinuing treatment with the drug.


CONCLUSIONS
In contrast to the adverse central nervous system symptoms associated with clarithromycin, those induced by azithromycin seem to take longer to resolve, perhaps based upon the longer elimination half-life of the latter antimicrobial, particularly in geriatric women.
Cone
Lawrence A
LA
Department of Medicine, Eisenhower Medical Center, Rancho Mirage, California, USA.
Padilla
Lester
L
Potts
Barbara E
BE
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D017963:Azithromycin / Q000008:administration & dosage / Q000009:adverse effects*; D003693:Delirium / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008297:Male
D000900:Anti-Bacterial Agents; D017963:Azithromycin