From: judgebean23x@gmail.com   
      
   Study Sees Possible Link Between Antibiotics and Delirium in Patients    
      
   Temporary confusion often caused by drugs, including common antimicrobials,   
   research suggests    
      
   hands with a hospital wrist band    
   By Maureen Salamon    
   HealthDay Reporter    
      
   WEDNESDAY, Feb. 17, 2016 (HealthDay News) -- Delirium in hospitalized patients   
   might be linked to common antibiotics more often than once believed, according   
   to new research.    
      
   Delirium -- mental confusion that may be paired with hallucinations and   
   agitation -- is often caused by medications. But, antibiotics are not   
   typically the first type of drug suspected, said study lead author Dr. Shamik   
   Bhattacharyya, a neurologist at    
   Brigham and Women's Hospital in Boston.    
      
   Reviewing case reports going back seven decades on patients given antibiotics   
   who later developed delirium and related issues, the scientists found that   
   nearly half suffered delusions or hallucinations. Seven out of 10 were found   
   to have abnormal    
   electrical activity in the brain.    
      
   "A key point in the study is that different antibiotics caused different types   
   of confusion," Bhattacharyya said. "The fact that antibiotics can cause   
   confusion has been recognized for many years, but it doesn't come into the   
   consciousness of many    
   doctors simply because there are many causes of confusion in patients with   
   infection. So being able to find distinct patterns was not something we   
   anticipated."    
      
   But one doctor not involved with the study said using case studies that   
   spanned 70 years may not have produced an accurate assessment of antibiotics   
   and their relationship to delirium.    
      
   Delirium strikes up to half of hospitalized patients and up to eight in 10   
   patients in intensive care units, according to study documents. Those with   
   delirium are more likely to have longer hospital stays and suffer other   
   complications such as falls and    
   death, and are also more likely to enter a nursing home.    
      
   More than 262 million courses of antibiotics are prescribed each year in the   
   United States, according to the U.S. Centers for Disease Control and   
   Prevention. This equates to more than five antibiotic prescriptions written   
   each year for every six people    
   in the United States.    
      
   Bhattacharyya and his colleagues combed through case reports going back to   
   1946, finding 391 cases where patients given antibiotics developed delirium   
   and other brain problems. While nearly half suffered delusions or   
   hallucinations, 14 percent had    
   seizures, 15 percent had involuntary muscle twitching and 5 percent lost   
   control of body movements. One quarter of those with delirium also suffered   
   kidney failure.    
      
   A total of 54 different antibiotics from 12 classes were involved in the   
   cases, ranging from commonly used antibiotics such as sulfonamides and   
   ciprofloxacin (Cipro) to intravenous penicillin and cefepime (Maxipime).   
   Patients' average age was 54.    
      
      
   Three types of antibiotics-related delirium and other brain problems were   
   identified by Bhattacharyya and his team, apparently the first time these   
   patterns were delineated, he said.    
      
   "We don't know the rate at which antibiotics cause confusion," said   
   Bhattacharyya, also a neurology instructor at Harvard Medical School. "We   
   don't have a good sense of how prevalent this is, but it's thought to be   
   under-recognized in health care circles    
   and even less well-known in the general population."    
      
   The study authors noted that the elderly would likely be most susceptible to   
   harmful effects from antibiotics. When patients develop delirium, doctors   
   should consider whether an antibiotic drug is the culprit. The sooner a   
   problem drug is discontinued,    
   the faster the patient will return to a normal mental state, the researchers   
   said.    
      
   The study findings were published online Feb. 17 in the journal Neurology.    
      
   Dr. Waimei Amy Tai, a neurology hospitalist at Christiana Care Health System   
   in Wilmington, Del., said that using case studies that dated back 70 years may   
   have skewed the results. Penicillin use was just starting to become prevalent   
   at that point, she    
   said, and it may have been harder to tease out whether a patient's infection   
   caused confusion instead of an antibiotic used to treat it.    
      
   Tai agreed with Bhattacharyya that delirium can be highly dangerous to   
   patients.    
      
   "I think it's important for physicians as well as family members to think   
   about the possible reversible causes of delirium and try to minimize them as   
   much as possible," said Tai, who wasn't involved in the new study. "By   
   avoiding certain antibiotics or    
   reducing their use, that might really help the patient."    
      
   More information    
      
   The Hospital Elder Life Program has more about delirium.   
      
   SOURCES: Shamik Bhattacharyya, M.D., neurologist, Brigham and Women's Hospital   
   and, instructor, neurology, Harvard Medical School, Boston; Waimei Amy Tai,   
   M.D., neurology hospitalist, Christiana Care Health System, Wilmington, Del.;   
   Feb. 17, 2016, online,   
    Neurology    
      
   Last Updated: Feb 17, 2016    
      
      
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