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Fluoroquinolones (FQ) remain cornerstones of antimicrobial therapy despite a growing list of concerns about side effects such as aortic dissection and peripheral neuropathy. Although in vitro demonstration that FQs inhibit GABA activity has validated case reports of seizures associated with their use, large-scale assessment of the epileptogenic features of FQs are lacking.
Investigators in Israel conducted a retrospective observational study of seizure incidence in 52,722 hospitalized patients who received FQs (ofloxacin, ciprofloxacin, levofloxacin, or moxifloxacin) or macrolides (azithromycin or roxithromycin) during a 12-year period at a large academic medical center. Seizures occurred in 33 patients receiving FQs (incidence, 1:5422 treat…