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We describe a case of symptomatic, refractory hypoglycaemia secondary to TMP\u2013SMX in a patient being treated for <jats:italic>Stenotrophomonas maltophilia<\/jats:italic> bacteraemia, which required treatment with 10 hours of intravenous dextrose (including several 50% dextrose boluses), as well as intramuscular glucagon and octreotide. We reviewed previous case reports described in the literature of TMP\u2013SMX-induced hypoglycaemia, in which renal insufficiency was noted to be a common predisposing risk factor in an overwhelming majority of cases. In refractory cases of TMP\u2013SMX-induced hypoglycaemia, intravenous octeotride may be considered for treatment.<\/jats:p>","DOI":"10.1136\/bcr-2020-240232","type":"journal-article","created":{"date-parts":[[2021,5,7]],"date-time":"2021-05-07T11:56:18Z","timestamp":1620388578000},"page":"e240232","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Trimethoprim\u2013sulfamethoxazole-induced refractory hypoglycaemia successfully treated with octreotide"],"prefix":"10.1136","volume":"14","author":[{"given":"Jordan Kit","family":"Mah","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, McGill University, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Negreanu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, McGill University, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2785-9398","authenticated-orcid":false,"given":"Suhaib","family":"Radi","sequence":"additional","affiliation":[{"name":"Endocrine Oncology, Princess Margaret Cancer Center, University of Toronto, Toronto, Ontario, Canada"},{"name":"Division of Endocrinology, Department of Medicine, King Saud bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stavroula","family":"Christopoulos","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, McGill University, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,5,7]]},"reference":[{"key":"2025082800100373000_14.5.e240232.1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.111152"},{"key":"2025082800100373000_14.5.e240232.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.13.1652"},{"key":"2025082800100373000_14.5.e240232.3","unstructured":"Antimicrobial Therapy I . 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