Pijlman A H, Kuck E M, van Puijenbroek E P, Hoekstra J B
Afd. Interne Geneeskunde, Diakonessenhuis, Bosboomstraat 1, 3582 KE Utrecht.
Ned Tijdschr Geneeskd. 2001 Feb 3;145(5):225-8.
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.
克拉霉素是一种应用广泛的新型抗生素。其频繁使用解释了为何先前报道的副作用现在很少出现。两名患者，一名74岁男性和一名56岁女性，在作为幽门螺杆菌根除治疗一部分使用克拉霉素后出现谵妄，推测是对克拉霉素的特异反应所致。临床前和临床研究未发现对中枢神经系统有副作用。目前，已有数名患者出现了推测与使用克拉霉素有关的谵妄。此外，一些患者再次用药后反应呈阳性。最后，荷兰药物警戒基金会（Lareb）收到了17份关于使用克拉霉素后出现精神副作用的报告，其中7例为谵妄。这些事实综合起来使得因果关系很可能成立。
