Introduction: Cefixime, a third-generation cephalosporin, is commonly used in different
infections. Tolerance is pretty good even if some side effects can be frequent like digestive disorders.
Other effects, not mentioned in the Summary of Product Characteristics, can occur.
Methods: We report a case of recurrent, acute oromandibular dystonia in a cefixime-treated adult.
Case-report: After the third dose of cefixime, prescribed for a bronchial infection, a patient
experienced a first episode of oromandibular dystonia. Then, after each ingestion, the same effects
appeared. After the discontinuation of cefixime, there was no recurrence. The diagnosis of acute
oromandibular dystonia has been confirmed by a neurologist.
Discussion: Some cases of dystonia have been published with other β-lactams antibiotics and with
cefixime but they concerned children. Different mechanisms are proposed to explain the occurrence of
dystonia during a treatment with cefixime. They involved certain neurotransmitters like dopamine,
acetylcholine or GABA.
Conclusion: Even if dystonia is not a side effect mentioned in the SPC, the drug’s potential causal role
must always be considered in case of involuntary contraction of muscles in a patient treated with
cefixime or any other β-lactam antibiotics.