Off-label use of otic ciprofloxacin/dexamethasone led to hyperglycemia in infant: Case report

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-06-20T10:15:00+05:30 | Updated On 20 Jun 2022 3:53 PM IST

USA: A recent case report, published in the Annals of Otology, Rhinology & Laryngology, describes the case of hyperglycemia in a child with Type 1 diabetes following the off-label use of otic ciprofloxacin/dexamethasone drops in the nasal passage. The article also reviews previous reports of adverse endocrine effects from intranasal corticosteroids in pediatric patients.

Tom Ben-Dov, New York University School of Medicine, New York, NY, USA, and colleagues describe the clinical case and conducted a literature review of MEDLINE (PubMed) and EMBASE.

The case in question is of a 9-month-old female with a history of Type 1 diabetes who underwent unilateral choanal atresia repair and was started on 1 week of ciprofloxacin 0.3%/dexamethasone 0.1% otic drops twice a day for choanal obstruction with granulation tissue.

While the patient's airway patency improved, average daily blood glucose increases by 40 to 50 points were noted on the patient's continuous glucose monitor. The hyperglycemia resolved within 2 days after switching to mometasone furoate 0.05% spray.

They also reviewed 21 pediatric otolaryngology cases of iatrogenic Cushing's syndrome associated with on- and off-label use of topical steroid suspensions in the airway. Patients ranged from 3 months to 16 years in age and used doses of 50 μg/day to 2 mg/day.

"To the best of our knowledge, this is the first reported pediatric case of increased blood glucose levels associated with intranasal steroid suspensions," the researcher's team wrote in their study.

They suggest that when prescribing these medications for off-label use in infants and small children, particularly among patients with underlying endocrine disorders such as diabetes, counseling families on precise dose administration and potential endocrine disturbances is critical.

Reference:

Ben-Dov T, Yang J, April MM. Off-Label Use of Ciprofloxacin/Dexamethasone Drops in the Pediatric Upper Airway: Case Presentation and Review of Adverse Effects. Annals of Otology, Rhinology & Laryngology. June 2022. doi:10.1177/00034894221104461

Annals of Otology Rhinology & Laryngologytype 1 diabetesinfantshyperglycemia

Source : Annals of Otology, Rhinology & Laryngology

Medha Baranwal

MSc. Biotechnology

Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751