title: Cefixime-induced Oromandibular Dystonia in an Adult: A Case Report.
abstract: BACKGROUND
  Cefixime, a third-generation cephalosporin, is commonly used in different infections. Tolerance is pretty good even if some side effects can be frequent like digestive disorders. Other effects, not mentioned in the Summary of Product Characteristics, can occur.
  
  
  METHODS
  We report a case of recurrent, acute oromandibular dystonia in a cefixime-treated adult.
  
  
  METHODS
  After the third dose of cefixime, prescribed for a bronchial infection, a patient experienced a first episode of oromandibular dystonia. Then, after each ingestion, the same effects appeared. After the discontinuation of cefixime, there was no recurrence. The diagnosis of acute oromandibular dystonia has been confirmed by a neurologist.
  
  
  CONCLUSIONS
  Some cases of dystonia have been published with other β-lactams antibiotics and with cefixime but they concerned children. Different mechanisms are proposed to explain the occurrence of dystonia during a treatment with cefixime. They involved certain neurotransmitters like dopamine, acetylcholine or GABA.
  
  
  CONCLUSIONS
  Even if dystonia is not a side effect mentioned in the SPC, the drug's potential causal role must always be considered in case of involuntary contraction of muscles in a patient treated with cefixime or any other β-lactam antibiotics.
authors.affiliation: Régional Pharmacovigilance Centre, Amiens University Hospital, Amiens,France.
authors.forename: Lisa
authors.initials: L
authors.lastname: Mondet
authors.affiliation: Régional Pharmacovigilance Centre, Amiens University Hospital, Amiens,France.
authors.forename: Fanny
authors.initials: F
authors.lastname: Radoube
authors.affiliation: Centre Régional de Pharmacovigilance de Picardie, Centre de Biologie Humaine, CHU Amiens- Picardie - Site Sud, 80054 Amiens Cedex 1,France.
authors.forename: Valerie
authors.initials: V
authors.lastname: Gras
authors.affiliation: Neurology Unit, Amiens University Hospital, Amiens,France.
authors.forename: Kamel
authors.initials: K
authors.lastname: Masmoudi
mesh_terms: D006801:Humans; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D020682:Cefixime / Q000009:adverse effects; D004421:Dystonia / Q000139:chemically induced / Q000175:diagnosis
chemical_list: D000900:Anti-Bacterial Agents; D020682:Cefixime
keywords: Cefixime; antibiotics.; cephalosporin; drug-induced; dystonia; oromandibular; β-lactams