Antibiotic-related adverse events in hospitalized chronic obstructive pulmonary disease patients with frequent exacerbation: a retrospective study

An increased risk of neuro-psychiatric related adverse events among fluoroquinolones (levofloxacin or ciprofloxacin) and ceftriaxone users was reported in primary care of hospitalized patients with Chronic Obstructive Pulmonary Disease (COPD). We evaluated the rate of antibiotic-related neuro-psychiatric adverse events during hospitalizations in patients with recurrences for COPD exacerbations. A single-center, cross-sectional, retrospective study was carried out in the Pulmonary Diseases Hospital including hospitalizations for COPD exacerbations from June 2014 to May 2019. Including criteria: > 40 years, > 2 hospitalizations for a patient in a year, at least one early re-admission < 30 days and treatment with at least one antibiotic of >24 hours. Fragile COPD patients, asthma, tuberculosis, cancer, known neurological or psychiatric diseases were excluded. Hospitalizations were divided into fluoroquinolone and non-fluoroquinolone treatments. Non-fluoroquinolone treatment was predominant (72.21% of hospitalizations). Neuro-psychiatric events were significantly higher in the fluoroquinolone group (77 hospitalizations), without differences among ciprofloxacin and levofloxacin. A higher incidence of antibiotic-related neurological events was reported in fluoroquinolone-treated patients hospitalized for recurrences of COPD exacerbations. These patients require special attention because of the risk of disease and treatment-induced neuropsychiatric disturbances.