Introduction: Moxifloxacin is an antibiotic used orally or parenterally in the emergency department (ED) for the treatment of various infections, especially acute exacerbation of chronic bronchitis and community-acquired pneumonia. The side effects of the drug are mainly on the gastrointestinal system, while the central nervous system side effects are rare. Case report: Herein, we present an elderly patient who had altered mental status associated with the use of moxifloxacin. Upon discontinuation of the drug, the patient quickly returned to baseline neurologic status. In the evaluation of altered mental status in elderly patients in the ED, much of the effort should be spent primarily on ruling out more complex diagnoses. However, this approach requires more invasive and advanced testing. Conclusion: Considering drug side effects among these more complicated diagnoses may increase noninvasive and radiation-free options for the patient and physician.
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