Abstract
An 88-year-old non-diabetic Chinese male with known stage 3 chronic kidney disease developed severe hypoglycemia and hyperinsulinemia during lomefloxacin treatment for chronic obstructive pulmonary disease exacerbation. Despite multiple treatments with dextrose solution, he continued to remain in the hypoglycemic state after a transient normoglycemic state following each dose. However, his hypoglycemia was resolved 2 days after the discontinuation of lomefloxacin. Other secondary causes of hypoglycemia were excluded. This suggests that lomefloxacin may be the cause of severe hypoglycemia and hyperinsulinemia in this elderly patient with decreased renal function. Clinicians should be aware of this potential fatal adverse effect of lomefloxacin and consider discontinuing the drug if hypoglycemia is observed. Since fluoroquinolones such as lomefloxacin could be accumulated in the body, capillary blood glucose level monitoring is necessary until the plasma glucose level remains normal for several days.
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References
Garber SM, Pound MW, Miller SM. Hypoglycemia associated with the use of levofloxacin. Am J Health Syst Pharm. 2009;66:1014–9.
Kelesidis T, Canseco E. Levofloxacin-induced hypoglycemia: a rare but lifethreatening side effect of a widely used antibiotic. Am J Med. 2009;122:e3–4.
Kendall C, Wooltorton E. People with diabetes should avoid antibiotic gatifloxacin. CMAJ. 2006;174:1089–90.
Lertxundi U, Cibrian F, Hernandez R, et al. Severe hypoglycemia associated with levofloxacin in an elderly diabetic inpatient. Eur Geriatr Med. 2012;3:181–3.
Singh N, Jacob JJ. Levofloxacin and hypoglycemia. Clin Infect Dis. 2008;46:1127.
Takehiro M, Kurose K, Fujimoto S, et al. Severe hypoglycemia induced by lomefloxacin hydrochloride in a hemodialytic patient. J Jpn Diabet Soc. 2002;45:293 (in Japanese).
Suda M, Minami T, Aono H, et al. Repeated hypoglycemia induced by lomefloxacin in chronic renal failure on hemodialysis. J Kyoto City Hosp J. 2000;20:41–6.
Moen MF, Zhan M, Hsu VD, et al. Frequency of hypoglycemia and its significance in chronic kidney disease. Clin J Am Soc Nephrol. 2009;4:1121–7.
Maeda N, Tamagawa T, Niki I, et al. Increase in insulin release from rat pancreatic islets by quinolone antibiotics. Br J Pharmacol. 1996;117:372–6.
Hori S, Kizu J, Kawamura M. Effect of fluoroquinolones on plasma glucose levels in fasted and glucose-loaded mice. J Infect Chemother. 2006;12:109–11.
Bito M, Tomita T, Komori M, et al. The mechanisms of insulin secretion and calcium signaling in pancreatic β-cells exposed to fluoroquinolones. Biol Pharm Bull. 2013;36:31–5.
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Authors would like to thank Dr. Prabhat K. Pokhrel for reviewing and editing this manuscript extensively.
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Zhang, J., Zheng, FP. & Li, H. Lomefloxacin-induced hypoglycemia in an elderly patient with chronic kidney disease:a case report. Int J Diabetes Dev Ctries 35, 374–377 (2015). https://doi.org/10.1007/s13410-014-0239-2
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DOI: https://doi.org/10.1007/s13410-014-0239-2