Possible Cefcapene Pivoxil- or Clarithromycin-Induced Severe Hyperglycemia in a Patient With Type 2 Diabetes: A Case Report
Bibliographic record
Abstract
There are various reasons for the deterioration of glycemic control observed in patients with diabetes, one of which is drug-induced hyperglycemia. Antibiotics, especially the fluoroquinolones, have been reported to be associated with glucose disturbances. However, induction of hyperglycemia by cephem or macrolide antibiotics has rarely, if ever, been reported. Here, we report the case of possible antibiotics-induced severe hyperglycemia in a patient with type 2 diabetes. A 67-year-old Japanese diabetic man, who was not using oral hypoglycemic agents or insulin but whose condition was controlled with diet and exercise, presented at an otolaryngology clinic with nasal discharge and rhinorrhea. His glycosylated hemoglobin (HbA1c) level had been stable at 6.6-7.2% for several years. He was diagnosed with acute sinusitis and given an oral cephem antibiotic, cefcapene pivoxil, for 1 week. His otolaryngeal symptoms were slight and disappeared soon. Thereafter, therapy was switched to a macrolide antibiotic, clarithromycin, for 3 weeks. Twenty-five days after the initiation of antibiotic therapy, severe hyperglycemia was pointed out; his random serum glucose and HbA1c levels were 29.4 mmol/L and 10.6%, respectively. The patient required insulin and oral hypoglycemic agent therapy. The Naranjo probability scale suggests that the relationship between the administration of cefcapene pivoxil or clarithromycin and the patient’s severe hyperglycemia might be possible. To the best of our knowledge, there has been no previous report of a deterioration in glycemic control in a patient with diabetes administered a cephem (cefcapene pivoxil) or macrolide (clarithromycin) antibiotic. Considering the global prescription of cephem and macrolide antibiotics, awareness of the fact that some patients are at high risk for impaired glucose tolerance is important when prescribing antibiotics. Further studies are warranted to determine the incidence rate of hyperglycemia among patients with diabetes who are administered cephem and macrolide antibiotics. J Med Cases. 2013;4(6):416-419 doi: https://doi.org/10.4021/jmc1274w
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.006 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".