Background: Fluoroquinolones, the most prescribed group of antibiotics (22 million people in the United States in 2015), are known to be associated with neuropsychiatric adverse effects. Currently there is no literature regarding genetic predictors of fluoroquinolone-associated neuropsychiatric toxicity. Our purpose is to identify novel genetic predictors of fluoroquinoloneassociated neuropsychiatric toxicity.
Methods: This study evaluated whole exome sequencing data. Saliva samples were obtained from persons with fluoroquinolone-associated neuropsychiatric toxicity who are connected via a social network relationship.
Results: The study sample consisted of 24 individuals, predominantly white (82.61%), female (65.22%), and under the age of 40 years (61%), including one patient who is 16 years old. Sixteen of the 24 sample patients experienced severe gastrointestinal distress, 9 experienced persistent headaches, and 18 experienced severe cognitive impairment. Thirteen study subjects (56.52%) had markers for one specific gene related to pharmaceutical metabolism. Among those who had the genetic marker, the majority was white (83.33%), female (66.67%), and had received the prescription for a urinary tract infection (36.36%). Among the 13 with the specific gene marker, 8 patients had severe gastrointestinal distress, 3 had persistent headaches, and 10 experienced severe cognitive impairment.
Conclusions: Our preliminary findings identified that certain patients may be at a higher risk for fluoroquinolone-associated neuropsychiatric toxicity based on the presence of a previously unreported genetic marker. Further studies need to be conducted to explore a causal relationship. Ongoing work is currently evaluating DNA for 100 additional patients from the same social network with fluoroquinolone-associated neuropsychiatric toxicity.