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Mental Confusion in a Patient Treated with Metronidazole — A Concentration‐Related Effect?
Author(s) -
Schentag Jerome J.,
Ziemniak John A.,
Greco Joseph M.,
Rainstein Miguel,
Buckley Richard J.
Publication year - 1982
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1982.tb03216.x
Subject(s) - confusion , metronidazole , psychology , chemistry , psychoanalysis , antibiotics , biochemistry
We report a case of serious mental confusion, hallucinations, and agitation in a 65 year old man, occurring in close relationship to the intravenous administration of metronidazole. The patient was treated twice, but at different dosages. The confusion and hallucinations occurred at the recommended daily dose of 2.0 g, but did not return at a daily dose of 500 mg. Metronidazole serum concentrations were obtained throughout both courses of therapy; CSF and tissue concentrations were obtained at autopsy. The mental confusion was associated with peak serum concentrations of approximately 40 μg/ml. Symptoms resolved within 24–48 hr after stopping metronidazole, and resolution was consistent with a metronidazole half life of 14 hr. We conclude that metronidazole can be associated with a dose‐ and serum concentration‐related mental confusion state, and that this side effect appears completely reversible upon discontinuing the drug.