Shah Mitanshu, Subhani Miral, Rizvon Kaleem, Mustacchia Paul
Department of Internal Medicine, Nassau University Medical Center, East Meadow, N.Y., USA.
Case Rep Gastroenterol. 2012 May;6(2):381-6. doi: 10.1159/000339713. Epub 2012 Jun 19.
The term 'antibiomania' refers to manic episodes that occur after a patient starts taking antibiotics. We report the case of a 49-year-old male who developed acute psychosis secondary to initiation of triple therapy for Helicobacter pylori eradication. Unlike with proton pump inhibitors, there have been several reported cases of central nervous system side effects and psychiatric consequences due to amoxicillin, however evidence points to clarithromycin as the likely culprit. On average onset of symptoms occurred within 1-5 days of initiating therapy. In all cases, symptoms resolved upon cessation of clarithromycin, mostly within 1-3 days. Unfortunately, the mechanism through which clarithromycin causes neurotoxicity remains unclear. Clinicians should be cognizant of psychiatric side effects secondary to clarithromycin, and discontinuation should be prompt for rapid recovery of mental status.
“抗生素躁狂症”一词指患者开始服用抗生素后出现的躁狂发作。我们报告了一例49岁男性病例，该患者在开始根除幽门螺杆菌的三联疗法后出现急性精神病。与质子泵抑制剂不同，已有数例关于阿莫西林导致中枢神经系统副作用和精神后果的报告病例，然而证据表明克拉霉素可能是罪魁祸首。症状平均在开始治疗后的1至5天内出现。在所有病例中，停用克拉霉素后症状均得到缓解，大多在1至3天内。不幸的是，克拉霉素导致神经毒性的机制仍不清楚。临床医生应认识到克拉霉素继发的精神副作用，并且应迅速停药以使精神状态快速恢复。
