Sathirapanya Pornchai
Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
Case Rep Neurol. 2017 Apr 24;9(1):81-85. doi: 10.1159/000472148. eCollection 2017 Jan-Apr.
Choreoathetosis (CAS) is attributed to a few neuropsychiatric drugs; however, it is scarcely reported with commonly used antibiotics.
To present a case of ceftriaxone (CTX)-induced CAS and to perform a literature review.
A medical teaching hospital.
An 83-year-old female with end stage renal disease was prescribed CTX 2 g/day intravenously and doxycycline (DXC) 200 mg/day orally for the treatment of acute community-acquired systemic infection. CAS developed 3 days after the administration of both drugs. Withdrawal of CTX and DXC yielded complete resolution of the CAS on the following day. Neither neurological adverse events related to DXC use nor pharmacological interaction between DXC and CTX was reported. Therefore, the CAS development was attributed to CTX.
CTX as well as other ß-lactam antibiotics induce glutamate excess in the striatum and cerebral cortex, resulting in neurological hyperexcitability disorders. Dosage adjustment of these antibiotics in relation to the patients' renal clearance is warranted.
舞蹈症（CAS）与少数神经精神药物有关；然而，常用抗生素导致舞蹈症的情况鲜有报道。
报告1例头孢曲松（CTX）诱发的舞蹈症病例并进行文献复习。
一家医学教学医院。
一名83岁终末期肾病女性因治疗急性社区获得性全身感染，静脉注射CTX 2克/天，口服强力霉素（DXC）200毫克/天。两种药物给药3天后出现舞蹈症。停用CTX和DXC后，舞蹈症在次日完全缓解。未报告与使用DXC相关的神经不良事件，也未报告DXC与CTX之间的药物相互作用。因此，舞蹈症的发生归因于CTX。
CTX以及其他β-内酰胺类抗生素可导致纹状体和大脑皮层谷氨酸过量，从而引起神经兴奋性过高障碍。有必要根据患者的肾脏清除率调整这些抗生素的剂量。
