Lomefloxacin-induced hypoglycemia in an elderly patient with chronic kidney disease:a case report

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.