Hypoglycemia and levofloxacin: a case report
Abstract
To the Editor–We report a case of an infrequent but potentially serious adverse effect of levofloxacin. The patient was an 86-year-old woman who lived in a nursing home. The patient has had hard-to-control type 2 diabetes mellitus for >40 years and has received treatment with 34 U of NPH insulin per day, occasionally supplemented with rapid insulin. The patient presented with renal insufficiency, with an estimated creatinine clearance value of 27.1 mL/min and chronic respiratory insufficiency, which required home oxygen administration. On 6 April 2007, the patient developed an episode of respiratory infection with fever, loose coughing, and worsening dyspnea, which made it necessary to increase the amount of oxygen that the patient received. She was treated with a regimen of levofloxacin (500 mg per 24 h). Three days after initiating treatment with levofloxacin, routine examinations revealed glycemic levels that were lower than those normally reported for the patient, who also experienced severe episodes of hypoglycemia (capillary glycemia, t;70 mg/dL). After the fifth day, glycemic values remained low, even though the administration of insulin had been interrupted, with severe episodes of hypoglycemia. During the fifth day, 3 doses of glucagon (1 mg) were administered subcutaneously. On the 6th day, levofloxacin was discontinued. From this point on, the patient was not treated with insulin and continued to receive an intravenous perfusion of 10% glucose in saline solution…
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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