Hypoglycemia-induced anoxic brain injury possibly associated with levofloxacin

Fatal hypoglycemia with levofloxacin use in an elderly patient in the post-operative period

“…Similar to other reports with levofloxacin, the hypoglycemia was documented within 24 h of starting levofloxacin [3][4][5][6]. Our patient was elderly and had underlying renal impairment as seen in other reports.…”

“…Levofloxacin has been previously reported to cause hypoglycemia in four instances [3][4][5][6]. In two of these instances, the delays in recognizing the etiology of hypoglycemia led to unfortunate consequences [3,5].…”

Cardiovascular and metabolic safety profiles of the fluoroquinolones

“…Specifically, the RR of hypoglycemia with gatifloxacin was more than twofold higher than with levofloxacin, the molecule more frequently captured among case reports collected [9,19,25,[74][75][76]80]. In keeping with this, both descriptive and etiological surveys showed that levofloxacin users were more at risk of dysglycemia than those exposed to ciprofloxacin [9,19,25,[56][57][58][59][60][61][62][63][64][74][75][76]. Moreover, almost all case reports and series confirmed that predisposing factors, such as diabetes, kidney failure and use of antidiabetics (e.g., glyburide) were able to increase the risk of blood glucose disorders within a short time of onset.…”

Hypoglycemia and Levofloxacin: A Case Report

“…Our patient experienced renal insufficiency, with an estimated creatinine clearance of 27.1 mL/min. Even though the majority of cases of hypoglycemia due to levofloxacin use have been reported in patients taking oral antidiabetic agents, specifically sulphonylureas [4,8,9], there have also been cases in patients who receive insulin or in diabetic patients who are solely undergoing dietary treatment [5]. To the best of our knowledge, this is the first published case of hypoglycemia caused by levofloxacin in a diabetic patient treated exclusively with insulin.…”