Seizures associated with levofloxacin: case presentation and literature review.
OBJECTIVE
We present a case of a patient who developed seizures shortly after initiating treatment with levofloxacin and to discuss the potential drug-drug interactions related to the inhibition of cytochrome P450 (CYP) 1A2 in this case, as well as in other cases, of levofloxacin-induced seizures.


METHODS
Several biomedical databases were searched including MEDLINE, Cochrane and Ovid. The main search terms utilized were case report and levofloxacin. The search was limited to studies published in English.


RESULTS
Six cases of levofloxacin-induced seizures have been reported in the literature. Drug-drug interactions related to the inhibition of CYP1A2 by levofloxacin are likely involved in the clinical outcome of these cases.


CONCLUSIONS
Clinicians are exhorted to pay close attention when initiating levofloxacin therapy in patients taking medications with epileptogenic properties that are CYP1A2 substrates.
Bellon
Alfredo
A
Centre de Psychiatrie et Neurosciences, INSERM U894 Laboratoire de Physiopathologie des Maladies Psychiatriques, Paris, France. alfredobellon@yahoo.com
Perez-Garcia
Gonzalo
G
Coverdale
John H
JH
Chacko
Ranjit C
RC
D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016470:Bacteremia / Q000175:diagnosis / Q000382:microbiology*; D019388:Cytochrome P-450 CYP1A2 / Q000187:drug effects / Q000378:metabolism; D018492:Dopamine Antagonists / Q000009:adverse effects; D004334:Drug Administration Schedule; D004357:Drug Synergism; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000175:diagnosis* / Q000188:drug therapy; D064704:Levofloxacin; D008297:Male; D008787:Metoclopramide / Q000009:adverse effects; D008803:Mianserin / Q000009:adverse effects / Q000031:analogs & derivatives; D008875:Middle Aged; D000078785:Mirtazapine; D015242:Ofloxacin / Q000008:administration & dosage / Q000009:adverse effects*; D010726:Phosphodiesterase Inhibitors / Q000009:adverse effects; D012640:Seizures / Q000139:chemically induced*; D013806:Theophylline / Q000009:adverse effects
D000317:Adrenergic alpha-Antagonists; D000900:Anti-Bacterial Agents; D018492:Dopamine Antagonists; D010726:Phosphodiesterase Inhibitors; D008803:Mianserin; D064704:Levofloxacin; D000078785:Mirtazapine; D015242:Ofloxacin; D013806:Theophylline; D019388:Cytochrome P-450 CYP1A2; D008787:Metoclopramide
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