Acute Dystonic Reaction Associated with Cefuroxime Axetil in a Child Running Title: Acute Dystonic Reaction

Dystonia is an extrapyramidal motor function disorder characterized by intermittent spasmodic or sustained involuntary muscle contractions of the face, neck, trunk, pelvis and extremities causing repetitive movements and postural abnormalities [1,2]. The abnormal posture may induce significant anxiety and distress for the patient and relatives. In adults, the head and neck muscles are the most frequently involved [3,4]. If muscles of pharynx and larynx are affected life-threatening events may also occur [5,6]. Although dystonia is mostly seen as an adverse drug reaction, risk factors include young age, male gender, history of acute dystonic reaction and cocaine use [2] Prevalence varies according to individual tendency, type and dosage of drug and duration of exposure [3]. Herein we present a case of dystonic reaction in a child associated with the use of cefuroxime axetil and make up an awareness of this adverse drug reaction when prescribing such antibiotic in children. To our knowledge, this is the first cefuroxime axetil-related dystonic reaction in the literature.