Vol. 7, Issue 2, Part F (2025)

Levofloxacin is a widely prescribed third-generation fluoroquinolone antibiotic effective against respiratory and urinary tract infections. Though generally safe, it has been rarely associated with life-threatening adverse effects such as severe hypoglycemia. We report the case of a 69-year-old retired school teacher with chronic kidney disease and hypertension who developed prolonged, refractory hypoglycemia after initiation of levofloxacin for an acute exacerbation of chronic bronchitis. Despite supportive care including intravenous dextrose and glucagon, hypoglycemia persisted until the antibiotic was discontinued, resulting in full recovery. This case underlines the importance of heightened clinical suspicion for rare but serious metabolic complications of levofloxacin, especially in vulnerable populations with renal impairment.