From the Research
Cefazolin is unlikely to cause sundowning syndrome in geriatric patients, as there is no direct evidence linking the two, and sundowning is more commonly associated with dementia, sleep disorders, and circadian rhythm disturbances 1. Sundowning, characterized by confusion and agitation in the late afternoon or evening, is a complex phenomenon that can occur in older adults, particularly those with dementia. While cefazolin, an antibiotic, is not typically associated with sundowning, any medication that crosses the blood-brain barrier has the potential to cause neurological side effects, especially in the elderly. Geriatric patients are more susceptible to medication side effects due to age-related changes in metabolism and drug clearance. If sundowning symptoms occur while a patient is on cefazolin, the healthcare provider should be notified immediately. They may consider adjusting the dose, changing the timing of administration, or switching to an alternative antibiotic if appropriate. To minimize the risk of neurological side effects:
- Use the lowest effective dose of cefazolin
- Monitor renal function and adjust dosing accordingly
- Be vigilant for any changes in mental status or behavior It's essential to note that infection itself can cause confusion in older adults, so distinguishing between medication side effects and symptoms of the underlying condition is crucial. A recent study published in 2023 provides an overview of sundowning syndrome, its pathophysiology, and therapeutic approaches, but does not mention cefazolin as a potential cause 1. Another study from 2000 suggests that melatonin may be useful in alleviating sundowning symptoms, but this is not directly related to cefazolin use 2. Overall, the current evidence does not support a direct link between cefazolin and sundowning syndrome in geriatric patients.