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Updated: May 19, 2026

Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro
Published on: January 31, 2022
[Levofloxacin hepatotoxicity. Higher risk in diabetics?]
Joana Coelho1, Carla Gonçalves, Sara Leitão
1Serviço de Medicina Interna, Hospitais da Universidade de Coimbra, Coimbra, Portugal.
Abstract:
Levofloxacin, commonly used in medical practice, is prescribed to treat pneumonia in patients with comorbidities. Although generally well tolerated and safe, it has a well-known, but rarely reported, undercharacterized and ill-identified hepatotoxicity, with an unknown signature. With cases of fulminant hepatitis, cholestasis episodes reveal an apparently benign progression. Its capability of interference with the glucidic metabolism is also well-known, and the susceptibility factors to these events include age, presence of multiple pathologies and polymedication. The link between Diabetes Mellitus and hepatotoxicity has not yet been identified. Nonetheless, reports of several cases in literature along with the identification of two cases in insulin-treated diabetics, lead to believe that this is a higher-risk group.
Insights
Levofloxacin can cause liver injury (hepatotoxicity), particularly in diabetic patients. This study highlights the need for caution when prescribing this antibiotic to individuals with diabetes mellitus.
Area of Science:
- Pharmacology
- Hepatology
- Endocrinology
Background:
- Levofloxacin is a commonly prescribed antibiotic for pneumonia, especially in patients with comorbidities.
- While generally safe, levofloxacin is associated with undercharacterized hepatotoxicity and can interfere with glucose metabolism.
- The relationship between levofloxacin-induced hepatotoxicity and diabetes mellitus remains unclear.
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