{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:11:23Z","timestamp":1789726283053,"version":"4.0.1"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T00:00:00Z","timestamp":1628640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T00:00:00Z","timestamp":1628640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Psychiatry"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Antibiomania is a rare but recognized side effect with yet unclear definite pathogenesis although multiple hypotheses have been proposed. The novelty of this case is the suspected pharmacodynamic drug-drug interaction between clarithromycin and amoxicillin-clavulanic acid.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We present the occurrence of a brief manic episode concerning a 50-year-old man with no psychiatric history, first started on amoxicillin-clavulanic acid therapy and then switched to clarithromycin for left basal pneumonia. Shortly after the antibiotic prescription, he presented psychiatric symptomatology (logorrhea, elevated mood, irritability, increase in physical activity and delusions). The antibiotic was stopped and the patient received lorazepam (2.5\u2009mg p.o.) to treat psychomotor agitation. Approximately 12\u2009h after clarithromycin cessation, amelioration was already observed, supporting the diagnosis of a clarithromycin-induced manic episode. Amoxicillin-clavulanic acid was then reintroduced because of the pneumonia and psychiatric symptoms reemerged. This second antibiotic was also stopped, and 1 week later, the patient was symptom-free.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The emergence of psychiatric side effects related to antibiotherapy, which is a common treatment, can greatly impact a patient\u2019s quality of life. Early recognition and intervention could substantially influence the administered medical care and recovery. Moreover, given the widespread use of antibiotics including in combination, we thought our case report might be clinically useful as a clinical reminder relevant to the use of antibiotic combinations.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12888-021-03397-7","type":"journal-article","created":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T20:02:36Z","timestamp":1628712156000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Antibiomania: a case report of clarithromycin and amoxicillin-clavulanic acid induced manic episodes separately"],"prefix":"10.1186","volume":"21","author":[{"given":"Edith Paula","family":"Meszaros","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catheline","family":"Stancu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6387-6462","authenticated-orcid":false,"given":"Alessandra","family":"Costanza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Besson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Sarasin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4352-5531","authenticated-orcid":false,"given":"Guido","family":"Bondolfi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5775-4589","authenticated-orcid":false,"given":"Julia","family":"Ambrosetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,11]]},"reference":[{"issue":"1","key":"3397_CR1","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1097\/00004714-200202000-00012","volume":"22","author":"A Abouesh","year":"2002","unstructured":"Abouesh A, Stone C, Hobbs WR. Antimicrobial-induced mania (Antibiomania): a review of spontaneous reports. J Clin Psychopharmacol. 2002;22(1):71\u201381. https:\/\/doi.org\/10.1097\/00004714-200202000-00012.","journal-title":"J Clin Psychopharmacol"},{"key":"3397_CR2","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/j.jad.2017.05.029","volume":"219","author":"S Lambrichts","year":"2017","unstructured":"Lambrichts S, Van Oudenhove L, Sienaer P. Antibiotics and mania: a systematic review. J Affect Disord. 2017;219:149\u201356. https:\/\/doi.org\/10.1016\/j.jad.2017.05.029.","journal-title":"J Affect Disord"},{"issue":"1","key":"3397_CR3","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1152\/jn.00134.2016","volume":"117","author":"EK Bichler","year":"2017","unstructured":"Bichler EK, Elder CC, Garcia PS. Clarithromycin increases neuronal excitability in CA3 pyramidal neurons through a reduction in GABAergic signalling. J Neurophysiol. 2017;117(1):93\u2013103. https:\/\/doi.org\/10.1152\/jn.00134.2016.","journal-title":"J Neurophysiol"},{"issue":"2","key":"3397_CR4","doi-asserted-by":"publisher","first-page":"123","DOI":"10.2165\/00002018-199921020-00005","volume":"21","author":"H Lode","year":"1999","unstructured":"Lode H. Potential interactions of the extended-spectrum fluoroquinolones with the CNS. Drug Saf. 1999;21(2):123\u201335. https:\/\/doi.org\/10.2165\/00002018-199921020-00005.","journal-title":"Drug Saf"},{"issue":"1","key":"3397_CR5","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1186\/s13054-017-1856-1","volume":"21","author":"LE Payne","year":"2017","unstructured":"Payne LE, Gagnon DJ, Riker RR, et al. Cefepime-induced neurotoxicity: a systematic review. Crit Care. 2017;21(1):276. Published 2017 Nov 14. https:\/\/doi.org\/10.1186\/s13054-017-1856-1.","journal-title":"Crit Care"},{"issue":"5","key":"3397_CR6","first-page":"429","volume":"133","author":"RC Young","year":"1978","unstructured":"Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. B J Psych Int. 1978;133(5):429\u201335.","journal-title":"B J Psych Int"},{"key":"3397_CR7","unstructured":"World Medical Association. WHO-UMC system for standardised case causality assessment. https:\/\/www.who.int\/medicines\/areas\/quality_safety\/safety_efficacy\/WHOcausality_assessment.pdf. Accessed on 1 May 2020."},{"issue":"2","key":"3397_CR8","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1038\/clpt.1981.154","volume":"30","author":"CA Naranjo","year":"1981","unstructured":"Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239\u201345. 7249508. https:\/\/doi.org\/10.1038\/clpt.1981.154.","journal-title":"Clin Pharmacol Ther"},{"issue":"8","key":"3397_CR9","doi-asserted-by":"publisher","first-page":"742","DOI":"10.1016\/S1473-3099(14)70780-7","volume":"14","author":"TP Van Boeckel","year":"2014","unstructured":"Van Boeckel TP, Gandra S, Ashok A, Caudron Q, Grenfell BT, Levin SA, et al. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Lancet Infect Dis. 2014;14(8):742\u201350. https:\/\/doi.org\/10.1016\/S1473-3099(14)70780-7.","journal-title":"Lancet Infect Dis"},{"issue":"20","key":"3397_CR10","doi-asserted-by":"publisher","first-page":"2191","DOI":"10.1001\/jama.2013.281053","volume":"310","author":"World Medical Association","year":"2013","unstructured":"World Medical Association. World medical association declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191\u20134.","journal-title":"JAMA."}],"container-title":["BMC Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12888-021-03397-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12888-021-03397-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12888-021-03397-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T20:04:55Z","timestamp":1628712295000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpsychiatry.biomedcentral.com\/articles\/10.1186\/s12888-021-03397-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,11]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["3397"],"URL":"https:\/\/doi.org\/10.1186\/s12888-021-03397-7","relation":{},"ISSN":["1471-244X"],"issn-type":[{"value":"1471-244X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,11]]},"assertion":[{"value":"1 October 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from the patient described in the case report. The need for local ethics committee approval was waived. The present study was conducted in compliance with the Helsinki Declaration of 1975, as revised in October 2013 [].","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this Case report. A copy of the written consent is available for review by the Editor of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"399"}}