Clarithromycin-Induced Visual Hallucinations

An independent 90-year-old woman presented to hospital with vivid and dynamic visual hallucinations following initiation of clarithromycin therapy. She had a background of previous cataract removal with good visual resolution and no significant deficits in visual acuity. Notably, she had been taking sertraline and quinine concurrently. Her symptoms fully resolved 72 hours following cessation of clarithromycin therapy. Visual hallucinations associated with clarithromycin could be explained by recent research demonstrating clarithromycin increases neuronal excitability by inhibiting gamma-aminobutyric acid-ergic signalling. Case reports of similar nature are rare, and we believe this report adds to a currently growing body of literature of visual hallucinations as a side effect of clarithromycin.