Levofloxacin and Risk Of Seizures

Levofloxacin is a fluoroquinolone antibiotic that is used to treat bacterial infections of the skin, sinuses, kidneys, bladder, or prostate. Fluoroquinolone antibiotics can cause serious or disabling side effects that may not be reversible. Taking levofloxacin may affect the brain or nervous system and cause seizures, epilepsy, stroke, changed brain structure, or kidney disease.

Awareness of personalised therapeutics for levofloxacin seems to be poor in clinical practice, and is reflected in prescribing patterns. Pharmacokinetic pharmacodynamic studies have raised concerns about suboptimal patient outcomes with the use of levofloxacin for some Gram-negative infections.1

A study on the pharmacogenetics of levofloxacin showed indirect evidence suggesting a temporal relationship between intravenous levofloxacin and new onset seizures. A patient in the study carried one variant allele for all three SNPs in ABCB1 gene. The study suggests that the seizures observed shortly after levofloxacin infusion were related to higher than expected penetration of the drug through the brain due to a genetically determined impaired activity of efflux proteins highly expressed in the blood-brain barrier. 2

ABCB1 gene is partly responsible for encoding a drug transporter in the blood-brain barrier. 3

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