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Metronidazole- and levofloxacin-induced psychotic disorders in chronic kidney patient
  1. Radmila Veličković-Radovanović1,2,
  2. Aleksandra Catić-Đorđević1,
  3. Katarina Dinić1,
  4. Jasmina Radivojević2,
  5. Olivera Žikić1,3,
  6. Tatjana Cvetković1,2,
  7. Branka Mitić1,2
  1. 1 Department of Pharmacy, Faculty of Medicine, University of Nis, Nis, Serbia
  2. 2 Clinic of Nephrology, Clinical Centre Nis, Nis, Serbia
  3. 3 Mental Health Protection Clinic, Clinical Centre Nis, Nis, Serbia
  1. Correspondence to Aleksandra Catić-Đorđević, Pharmacy, Faculty of Medicine, University of Nis, Nis 18000, Serbia; aleksandra1610{at}


We present a case which reports the occurrence of psychotic disorders after metronidazole and levofloxacin therapy in a chronic kidney patient while being treated for enterocolitis and urinary infection. A 48-year-old female was admitted to a hospital for the placement of a peritoneal dialysis catheter due to indicated peritoneal dialysis. During admission, symptoms of enterocolitis and urinary infection had occurred, so metronidazole and levofloxacin were introduced into therapy, respectively. After 4 days of metronidazole and 3 days of levofloxacin therapy, the patient became confused, disoriented, with signs of delirium. Since the diagnosis of psychoorganic disorder was made, the therapy with lorazepam and haloperidol was initiated, while metronidazole and levofloxacin were discontinued. Complete recovery 4 days after discontinuation indicates that the patient has experienced antibiotics-induced neurotoxicity. This is the first report of expressed neurotoxicity after the combination of metronidazole and levofloxacin in chronic kidney patients.

  • metronidazole
  • levofloxacin
  • psychotic disorders
  • chronic kidney disease
  • adverse effects

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