E-ISSN 2277-338X | ISSN 2320-4664
 

Case Report 


Levofloxacin induced hypoglycemia in a non-diabetic patient

Nirav Patel, Rubdeep Singh Bindra, Nilay Modi, Sagun Desai.

Cited by (1)

Abstract
Fluoroquinolones are generally regarded as safe antimicrobial agents with relatively few adverse effects or drug interactions. Because of their recognized safety profile and potent in vitro activity, fluoroquinolones have been widely used for the treatment of community- and hospital-acquired infections. Although uncommon, both hypoglycemia and hyperglycemia (dysglycemia) appear to occur with all the fluoroquinolones. It is usually reported in conjunction with impaired creatinine clearance and elderly diabetics receiving concomitant treatment with antidiabetic agents (especially sulfonylureas) or insulin. The exact mechanism of this effect is unknown but is postulated to be a result of blockage of adenosine 5'-triphosphate-sensitive potassium channels in pancreatic β-cell membranes.

Here we report a case of hypoglycemia in a hospitalized nondiabetic elderly patient in whom this life-threatening adverse effect was related in a temporal fashion to the administration of intravenous levofloxacin meant to cover pulmonary infection in a setting of subacute small bowel obstruction and septicaemia.

This case emphasizes the occurrence of profound and prolonged hypoglycemia consequent upon levofloxacin use, an adverse reaction that has been described with almost all members of the quinolone family of antibiotics. Taking into consideration the frequency of fluoroquinolone use in the hospital and ambulatory setting, clinicians should be cognizant of this potential adverse effect in non-diabetic patients treated with levofloxacin, and they should look out for symptoms of hypoglycemia and monitor blood glucose levels more frequently, especially early in the course of therapy.

Key words: Hypoglycemia, fluoroquinolones, levofloxacin


 
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REFERENCES
1. MSNBC. Antibiotic linked to blood-sugar problems; Bristol-Myers Squibb to stop making Tequin after increased warnings. Available from URL: www.msnbc.msn.com/id/12580698 (accessed 2009 Jan 27).
2. Frothingham R. Glucose homeostasis and fluoroquinolones: are there differences among drugs? Paper presented at 44th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy. Washington, DC; 2004.
3. Gajjar DA, LaCreta FP, Kollia GD, Stolz RR, Berger S, Smith WB, et al. Effect of multiple-dose gatifloxacin or ciprofloxacin on glucose homeostasis and insulin production in patients with non-insulin-dependent diabetes mellitus maintained with diet and exercise. Pharmacotherapy 2000;20(6 pt 2):76S-86. [DOI via Crossref]   
4. Helleis PF. Personal communication, Ortho-McNeil Medical Information, Clinical Communications, February 13, 2004.
5. Food and Drug Administration. Levofloxacin new drug application, (parts 1-4). Available from URL: http://www.fda.gov/cder/foi/nda/index.htm. Accessed October 2003.
6. Bristol-Myers Squibb. Data on file. Princeton, NJ; 2004.
7. Akpunonu B, Michaelis J, Uy CN, et al. Multicenter postmarketing assessment of levofloxacin in the treatment of adults with community-acquired pneumonia. Clin Infect Dis. 2004;38(suppl 1):S5-15. [DOI via Crossref]   
8. Saraya A, Yokokura M, Gonoi T, Seino S. Effects of fluoroquinolones on insulin secretion and beta-cell ATP-sensitive K+ channels. Eur J Pharmacol. 2004; 497:111-7. [DOI via Crossref]   
9. Owens RC Jr. Fluoroquinolone-associated dysglycemias: a tale of two toxicities. Pharmacotherapy. 2005; 25:1291-5. [DOI via Crossref]   
10. Metabolism of carbohydrates and formation of adenosine triphosphate. In: Guyton AC, ed. Textbook of medical physiology. 7th ed. Philadelphia: W. B. Saunders; 1996:808-17.
11. Tappy L, Jequier E, Schneiter P. Auto-regulation of glucose production. News Physiol Sci. 2000; 15:198-202.
12. Gupta V, Suri P. Diabetes in elderly patients. JK Pract. 2002; 91:258-9.
13. The use of WHO-UMC system for standardized case causality assessment (monograph on the internet). Uppsala: The Uppsala Monitoring centre. Available from URL: http://www.WHO-UMC.org/graphics/4409.pdf.
14. Naranjo CA, Busto U, Sellers EM, et al A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30:239-45. [DOI via Crossref]   
15. Hartwig SC, Siegel J, Schneider PJ. Preventability and severity assessment in reporting adverse drug reactions. Am J Hosp Pharm. 1992; 49: 2229-32.

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How to Cite this Article
Pubmed Style

Nirav Patel, Rubdeep Singh Bindra, Nilay Modi, Sagun Desai. Levofloxacin induced hypoglycemia in a non-diabetic patient. Int J Med Sci Public Health. 2013; 2(4): 1110-1113. doi:10.5455/ijmsph.2013.020720131


Web Style

Nirav Patel, Rubdeep Singh Bindra, Nilay Modi, Sagun Desai. Levofloxacin induced hypoglycemia in a non-diabetic patient. https://www.ijmsph.com/?mno=37755 [Access: April 05, 2022]. doi:10.5455/ijmsph.2013.020720131


AMA (American Medical Association) Style

Nirav Patel, Rubdeep Singh Bindra, Nilay Modi, Sagun Desai. Levofloxacin induced hypoglycemia in a non-diabetic patient. Int J Med Sci Public Health. 2013; 2(4): 1110-1113. doi:10.5455/ijmsph.2013.020720131



Vancouver/ICMJE Style

Nirav Patel, Rubdeep Singh Bindra, Nilay Modi, Sagun Desai. Levofloxacin induced hypoglycemia in a non-diabetic patient. Int J Med Sci Public Health. (2013), [cited April 05, 2022]; 2(4): 1110-1113. doi:10.5455/ijmsph.2013.020720131



Harvard Style

Nirav Patel, Rubdeep Singh Bindra, Nilay Modi, Sagun Desai (2013) Levofloxacin induced hypoglycemia in a non-diabetic patient. Int J Med Sci Public Health, 2 (4), 1110-1113. doi:10.5455/ijmsph.2013.020720131



Turabian Style

Nirav Patel, Rubdeep Singh Bindra, Nilay Modi, Sagun Desai. 2013. Levofloxacin induced hypoglycemia in a non-diabetic patient. International Journal of Medical Science and Public Health, 2 (4), 1110-1113. doi:10.5455/ijmsph.2013.020720131



Chicago Style

Nirav Patel, Rubdeep Singh Bindra, Nilay Modi, Sagun Desai. "Levofloxacin induced hypoglycemia in a non-diabetic patient." International Journal of Medical Science and Public Health 2 (2013), 1110-1113. doi:10.5455/ijmsph.2013.020720131



MLA (The Modern Language Association) Style

Nirav Patel, Rubdeep Singh Bindra, Nilay Modi, Sagun Desai. "Levofloxacin induced hypoglycemia in a non-diabetic patient." International Journal of Medical Science and Public Health 2.4 (2013), 1110-1113. Print. doi:10.5455/ijmsph.2013.020720131



APA (American Psychological Association) Style

Nirav Patel, Rubdeep Singh Bindra, Nilay Modi, Sagun Desai (2013) Levofloxacin induced hypoglycemia in a non-diabetic patient. International Journal of Medical Science and Public Health, 2 (4), 1110-1113. doi:10.5455/ijmsph.2013.020720131





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