Journal of Neurology

, Volume 266, Issue 5, pp 1272–1273 | Cite as

Defining metronidazole-induced encephalopathy

  • Akira KuriyamaEmail author
  • Jeffrey L. Jackson
Letter to the Editors


Compliance with ethical standards

Conflicts of interest

All authors declare that they have no conflict of interest.

Ethical standards

This article does not contain any studies with human participants or animals performed by any of the authors.


  1. 1.
    Sorensen CG, Karlsson WK, Amin FM, Lindelof M (2018) Metronidazole-induced encephalopathy: a systematic review. J Neurol. Google Scholar
  2. 2.
    Kuriyama A, Jackson JL, Doi A, Kamiya T (2011) Metronidazole-induced central nervous system toxicity: a systematic review. Clin Neuropharmacol 34(6):241–247. CrossRefGoogle Scholar
  3. 3.
    Rohatgi A, Monga R, Goyal D (2000) Metronidazole induced acute confusional agitated state. J Assoc Phys India 48(2):261Google Scholar
  4. 4.
    Bhattacharyya S, Darby R, Berkowitz AL (2014) Antibiotic-induced neurotoxicity. Curr Infect Dis Rep 16(12):448. CrossRefGoogle Scholar
  5. 5.
    Bhattacharyya S, Darby RR, Raibagkar P, Gonzalez Castro LN, Berkowitz AL (2016) Antibiotic-associated encephalopathy. Neurology 86(10):963–971. CrossRefGoogle Scholar
  6. 6.
    Biancone L, Annese V, Ardizzone S, Armuzzi A, Calabrese E, Caprioli F, Castiglione F, Comberlato M, Cottone M, Danese S, Daperno M, D’Inca R, Frieri G, Fries W, Gionchetti P, Kohn A, Latella G, Milla M, Orlando A, Papi C, Petruzziello C, Riegler G, Rizzello F, Saibeni S, Scribano ML, Vecchi M, Vernia P, Meucci G, Italian Group for the Study of Inflammatory Bowel D (2017) Safety of treatments for inflammatory bowel disease: Clinical practice guidelines of the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD). Digest Liver Dis 49(4):338–358. CrossRefGoogle Scholar
  7. 7.
    Cornely OA, Nathwani D, Ivanescu C, Odufowora-Sita O, Retsa P, Odeyemi IA (2014) Clinical efficacy of fidaxomicin compared with vancomycin and metronidazole in Clostridium difficile infections: a meta-analysis and indirect treatment comparison. J Antimicrob Chemother 69(11):2892–2900. CrossRefGoogle Scholar
  8. 8.
    Daniels LM, Kufel WD (2018) Clinical review of Clostridium difficile infection: an update on treatment and prevention. Expert Opin Pharmacother 19(16):1759–1769. CrossRefGoogle Scholar
  9. 9.
    Goolsby TA, Jakeman B, Gaynes RP (2018) Clinical relevance of metronidazole and peripheral neuropathy: a systematic review of the literature. Int J Antimicrob Agents 51(3):319–325. CrossRefGoogle Scholar
  10. 10.
    Leong C, Zelenitsky S (2013) Treatment strategies for recurrent clostridium difficile infection. Can J Hosp Pharm 66(6):361–368Google Scholar
  11. 11.
    McDonald LC, Gerding DN, Johnson S, Bakken JS, Carroll KC, Coffin SE, Dubberke ER, Garey KW, Gould CV, Kelly C, Loo V, Shaklee Sammons J, Sandora TJ, Wilcox MH (2018) Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis 66(7):e1–e48. CrossRefGoogle Scholar
  12. 12.
    Ooijevaar RE, van Beurden YH, Terveer EM, Goorhuis A, Bauer MP, Keller JJ, Mulder CJJ, Kuijper EJ (2018) Update of treatment algorithms for Clostridium difficile infection. Clin Microbiol Infect 24 (5):452–462. CrossRefGoogle Scholar
  13. 13.
    Chai J, Lee CH (2018) Management of primary and recurrent clostridium difficile infection: an update. Antibiotics (Basel Switzerland). Google Scholar
  14. 14.
    Zutshi D (2017) Medication-induced seizures and status epilepticus. In: Husain A, Sinha S (eds) Continuous EEG monitoring: principles and practice. Springer, New York, pp 361–382CrossRefGoogle Scholar
  15. 15.
    Sarna JR, Furtado S, Brownell AK (2013) Neurologic complications of metronidazole. Can J Neurol Sci 40(6):768–776CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Emergency and Critical Care CenterKurashiki Central HospitalOkayamaJapan
  2. 2.Department of Medicine, GIM SectionMedical College of WisconsinMilwaukeeUSA

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