Various antimicrobial classes are implicated with neurotoxicity. The classes with the most reported cases include fluoroquinolones, macrolides, sulfonamides, nitrofurans, and β-lactams. A higher risk of developing various symptoms of neurotoxicity was found in the elderly with use of piperacillin and tazobactam, cephalosporins, carbapenems, aminoglycosides, trimethoprim and sulfamethoxazole, nitrofurantoin, linezolid, and possibly the fluoroquinolones. Potential mechanisms of neurotoxicity differ between the agents. The etiology of neurotoxicity with some agents is not fully elucidated. Incidence may increase with reported risk factors, renal dysfunction, or drug interactions.