BACKGROUND AND AIM: Fluoroquinolones are antimicrobial agents with a broad spectrum of activity against gram-positive, gram-negative, and anaerobic organisms. They are widely used in surgical practice and are generally considered safe. Hypoglycemia because of use of levofloxacin is a rarely reported complication. This report of a case of a surgical patient highlights this potentially fatal complication. PATIENT: An elderly, non-diabetic patient with renal impairment presented with a possible duodenal perforation. After successful surgery, the patient developed recurrent hypoglycemic episodes in the post-operative period after use of levofloxacin. Delay in recognition of the cause of hypoglycemia led to irreversible brain damage and death. RESULTS: The calculated Naranjo adverse drug reaction probability scale criteria suggest the possibility that these episodes were related to levofloxacin. The mechanism of hypoglycemia with levofloxacin relates to the potential inhibition of the K(ATP) channel on the pancreatic beta cell by the drug. CONCLUSION: The case report highlights the need to be aware of this potentially fatal complication of a drug commonly used in surgical practice.
BACKGROUND AND AIM: Fluoroquinolones are antimicrobial agents with a broad spectrum of activity against gram-positive, gram-negative, and anaerobic organisms. They are widely used in surgical practice and are generally considered safe. Hypoglycemia because of use of levofloxacin is a rarely reported complication. This report of a case of a surgical patient highlights this potentially fatal complication. PATIENT: An elderly, non-diabeticpatient with renal impairment presented with a possible duodenal perforation. After successful surgery, the patient developed recurrent hypoglycemic episodes in the post-operative period after use of levofloxacin. Delay in recognition of the cause of hypoglycemia led to irreversible brain damage and death. RESULTS: The calculated Naranjo adverse drug reaction probability scale criteria suggest the possibility that these episodes were related to levofloxacin. The mechanism of hypoglycemia with levofloxacin relates to the potential inhibition of the K(ATP) channel on the pancreatic beta cell by the drug. CONCLUSION: The case report highlights the need to be aware of this potentially fatal complication of a drug commonly used in surgical practice.
Authors: C A Naranjo; U Busto; E M Sellers; P Sandor; I Ruiz; E A Roberts; E Janecek; C Domecq; D J Greenblatt Journal: Clin Pharmacol Ther Date: 1981-08 Impact factor: 6.875
Authors: Laura Y Park-Wyllie; David N Juurlink; Alexander Kopp; Baiju R Shah; Therese A Stukel; Carmine Stumpo; Linda Dresser; Donald E Low; Muhammad M Mamdani Journal: N Engl J Med Date: 2006-03-01 Impact factor: 91.245