Dasuqi SA, Alshaer LM, Omran RA, Hamad MA. Recurrent ciprofloxacin induced hypoglycemia in a non-diabetic patient: A case report. World J Pharmacol 2023; 12(2): 12-17 [DOI: 10.5497/wjp.v12.i2.12]
Corresponding Author of This Article
Shereen A Dasuqi, BCPS, BSc, MSc, Adjunct Associate Professor, Chief Pharmacist, Pharmacist, Department of Pharmacy, King Khalid University Hospital, King Saudi University Medical City, Riyadh KSA, Riyadh 11362, Saudi Arabia. shereen.dasuqi@gmail.com
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Pharmacol. Mar 22, 2023; 12(2): 12-17 Published online Mar 22, 2023. doi: 10.5497/wjp.v12.i2.12
Recurrent ciprofloxacin induced hypoglycemia in a non-diabetic patient: A case report
Shereen A Dasuqi, Linah M Alshaer, Rasha A Omran, Mohammed A Hamad
Shereen A Dasuqi, Department of Pharmacy, King Khalid University Hospital, King Saudi University Medical City, Riyadh 11362, Saudi Arabia
Linah M Alshaer, College of Pharmacy, Almaarefa University, Riyadh 11234, Saudi Arabia
Rasha A Omran, Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, University of Jordan, Amman 11180, Jordan
Mohammed A Hamad, Critical Care, King Khalid University Hospital, King Saud University Medical City, Riyadh 11362, Saudi Arabia
Mohammed A Hamad, Department of Acute Medicine, Wirral University Teaching Hospital NHS Foundation Trust, Arrowe Park Hospital, Wirral, Merseyside CH49 5PE, United Kingdom
Author contributions: All the authors wrote the manuscript, contributed to the case report, interpreted the data, and edited the manuscript; All authors have read and agreed to the published version of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shereen A Dasuqi, BCPS, BSc, MSc, Adjunct Associate Professor, Chief Pharmacist, Pharmacist, Department of Pharmacy, King Khalid University Hospital, King Saudi University Medical City, Riyadh KSA, Riyadh 11362, Saudi Arabia. shereen.dasuqi@gmail.com
Received: November 25, 2022 Peer-review started: November 25, 2022 First decision: January 31, 2023 Revised: February 13, 2023 Accepted: March 9, 2023 Article in press: March 9, 2023 Published online: March 22, 2023 Processing time: 115 Days and 12.9 Hours
Abstract
BACKGROUND
Fluoroquinolones are a class of broad-spectrum antimicrobials used for various bacterial infections. Frequent use of fluoroquinolones has been questioned due to severe associated adverse effects, including dysglycemia (hypoglycemia or hyperglycemia) due to an alternation in glucose metabolism. Recent clinical trials showed the association of poor clinical outcomes with hypoglycemia in critically ill patients without diabetes. Many predisposing factors worsen fluoroquinolone-induced hypoglycemia, including diabetes, concomitant medication use like sulfonylureas or insulin, renal disease, and the elderly.
CASE SUMMARY
We report a case of recurrent hypoglycemia after ciprofloxacin initiation for a 71-year-old, non-diabetic, critically ill patient despite the presence of total parenteral nutrition and nasogastric tube feeding. The adverse drug reaction probability (Naranjo) scale was completed with a probable adverse drug reaction. The hypoglycemia resolved entirely after ciprofloxacin discontinuation.
CONCLUSION
Although ciprofloxacin-induced hypoglycemia is rare, special consideration is needed for the elderly due to their higher susceptibility to adverse side effects.
Core Tip: Fluoroquinolones are a class of broad-spectrum antimicrobials used to treat various bacterial infections. Frequent use has been doubted due to associated adverse severe effects, including hypoglycemia or hyperglycemia due to an alternation in glucose metabolism. Recent clinical trials showed the association of poor clinical outcomes with hypoglycemia in critically ill patients without diabetes, emphasizing the harm of severe hypoglycemia. Ciprofloxacin has demonstrated the lowest incidence in the class in the diabetic population. We report a case of recurrent ciprofloxacin-induced hypoglycemia for non-diabetic critically ill patient despite total parenteral nutrition and nasogastric tube feeding. The hypoglycemia resolved successfully after ciprofloxacin discontinuation.
