静脉滴注莫西沙星致精神异常

1例79岁女性患者因医院获得性肺炎给予莫西沙星400mg，1次／d静脉滴注。当晚患者出现自言自语、焦虑，血压135／85mmHg（1mmHg=0．133kPa）。医嘱维持抗感染治疗。此后患者精神症状加重，表现为不认识家人、应答不切题、幻觉、狂躁不安等。应用莫西沙星5d后血压升至190／110mmHg，体温39．6℃，脑电图无异常。停用莫西沙星，改用美罗培南0．5g，1次／8h静脉滴注；并给予厄贝沙坦控制血压。2d后患者精神症状缓解，血压、体温恢复正常。2周后随访，出院后未再应用厄贝沙坦，血压基本正常，未再出现精神症状。

Psychosis induced by intravenous infusion of moxifloxacin

A 79-year-old female patient received an IV infusion of moxifloxacin 400 mg once daily for hospital acquired pneumonia. On the night, the patient experienced talking to herself, anxiety, and a blood pressure of 135/85 mm Hg. The anti-infective treatment continued following the doctor＇s advice. Hereafter she developed worsened psychic symptoms which included being not able to know families, irrelevant reply, hallucination, mania, and agitation. After infusion of moxifloxacin for 5 days, she presen- ted with a blood pressure of 190/110 mm Hg, a temperature of 39.6 ~C , and a normal electroencepha- logram. Moxifloxacin was stopped and changed to an IV infusion of meropenem 0.5 g once every 8 hours. Meanwhile, irbesartan was added to the regimen for control of blood pressure. Two days later, her psychic symptoms relieved and the blood pressure and temperature returned to within normal range. At a follow-up 2 weeks later, her blood pressure remained normal basically when irbesartan was not taken again after discharge and psychic symptoms did not recur.