헬리코박터 제균치료 항생제에 의한 hallucination. EndoTODAY 이준행

[StomachTODAY 044. 헬리코박터 제균치료 항생제에 의한 hallucination]

한 동문 후배를 만났습니다. 헬리코박터 제균치료 항생제에 의한 hallucination 환자를 경험하였다고 합니다. 헬리코박터 1차 제균치료약을 복용하는 중 한 모임에서 이상한 말을 하여 무척 곤란한 일을 겪었다는 환자였습니다. 헬리코박터 제균치료 약에 의한 hallucination/psychosis입니다.

한 증례 보고의 abstract를 옮깁니다 (Case Rep Gastroenterol. 2012).

Transient Psychotic Episode Induced by Helicobacter pylori Triple Therapy Treatment
The term ‘antibiomania’ refers to manic episodes that occur after a patient starts taking antibiotics. We report the case of a 49-year-old male who developed acute psychosis secondary to initiation of triple therapy for Helicobacter pylori eradication. Unlike with proton pump inhibitors, there have been several reported cases of central nervous system side effects and psychiatric consequences due to amoxicillin, however evidence points to clarithromycin as the likely culprit. On average onset of symptoms occurred within 1-5 days of initiating therapy. In all cases, symptoms resolved upon cessation of clarithromycin, mostly within 1-3 days. Unfortunately, the mechanism through which clarithromycin causes neurotoxicity remains unclear. Clinicians should be cognizant of psychiatric side effects secondary to clarithromycin, and discontinuation should be prompt for rapid recovery of mental status.

본문에 따르면 clarithromycin에서 흔하다고 합니다.

Antibiomania, a term used to describe antibiotic-induced manic episodes, is a rare but genuine side effect of some antimicrobials. Clarithromycin is among those more commonly associated with psychosis, with few reported cases involving amoxicillin. Onset of these symptoms typically occurs within 7 days of medication initiation and resolution of symptoms occurs 24-48 h after medication cessation.

[References]

1) EsoTODAY - 십이지장질환 증례토의

2) SmallTODAY - 소장질환 증례토의

3) ColonTODAY - 대장질환 증례토의

4) Dr. Sinn's LiverTODAY - 간질환 증례토의