Critical Care: Critical Care |

Hypoglycemia During Linezolid Therapy in Elder People Not Treated With Hypoglycemic Agents: Report of Three Cases and Review of the Literature FREE TO VIEW

Xiaoge Wang, DSc
Author and Funding Information

The Fourth Affiliated Hospital of China Medical University, Shenyang, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A143. doi:10.1016/j.chest.2016.02.149
Text Size: A A A
Published online

SESSION TITLE: Critical Care

SESSION TYPE: Case Report Poster

PRESENTED ON: Sunday, April 17, 2016 at 11:45 AM - 12:45 PM

INTRODUCTION: The most common ADRs of linezolid were diarrhea (2.8%-11.0%), headache (0.5%-11.3%) and nausea (3.4%-9.6%) as the drug instruction mentioned. Recently, linezolid-associated lactic acidosis and serotonin syndrome had also been reported increased [3-4] were rarely reported. The drug instruction also mentioned symptomatic hypoglycemia could happen in patients with diabetes who received both hypoglycemic agents and linezolids, but in the clinical work the symptom could happen in patients not treated with hypoglycemic agents.

CASE PRESENTATION: Original case 1 Male, 71 years old, with diabetes for 14 years, didn’t receive hypoglycemic agents, but only underwent diet-control and exercising; diagnosed “coronary heart disease” for 1 year. He was treated with biapenem 0.3g and linezolid 0.6g every 12 hours intravenous, On the 3rd day of his admission, the patient appeared diaphoresis, tremulousness and palpitation, these symptoms reliefed after taking food. On day 7, the patient got nosocomial infection and linezolid was reused. From day 8 to day 11, the hypoglycemia symptoms returned, the minimum value of blood glucose was 50.4 mg/dL, leading to a dextrose infusion. Original case 2 Male, 82 years old, denying diabetes history, treatment for him are as followed: biapenem 0.3g and linezolid 0.6g every 12 hours intravenous, On day 2, the patient appeared diaphoresis and palpitation with a minimum value of glucose reading 46.8 mg/dL. The symptoms disappeared after linezolid was stopped on the 4th day. Original case 3 Male, 84 years old, denying diabetes history, On day 8 he suffered hospital-associated infection, treated by cefoperazone-sulbactam 2.0g and linezolid 0.6g every 12 hours intravenous, 6 days after linezolid was prescribed, the patient appeared profuse sweating, glucose reading was 1.9mmol/L.

DISCUSSION: The warning and precautions section of the linezolid package insert was updated in 2012 to inform providers about the possibility of hypoglycemia in patients with diabetes receiving insulin or oral hypoglycemic agents when treated with linezolid, which pointed out that linezolid is a reversible inhibitor of monoamine oxidase, may lead to patients with diabetes with insulin or other hypoglycemic drugs hypoglycemia reaction.

CONCLUSIONS: hypoglycemia could happen in patient with or without diabetes, treated or not trated with hypoglycemic agents during linezolid therapy. Clinicians should be aware of this possibility when prescribing linezolid to avoid unnecessary dangers.

Reference #1: Moellering RC JR. linezolid: the first oxzolidinone antimicrobial [J]. Ann intern Med, 2003;138(2):135-142.

Reference #2: Diekena DI, Jones RN. Oxazolidinones: a review [J]. Drugs, 2000;59(1):7-16.

Reference #3: Garazzino S, Derosa FG, Bargiacchi O, et al. Haematological safely of long-term therapy with linezolid[J]. Int J Antimicrob Agents, 2007;29(4):480-483.

DISCLOSURE: The following authors have nothing to disclose: Xiaoge Wang

No Product/Research Disclosure Information




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543