A retrospective, comparative evaluation of dysglycemias in hospitalized patients receiving gatifloxacin, levofloxacin, ciprofloxacin, or ceftriaxone.

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Mohr JF, McKinnon PS, Peymann PJ, Kenton I, Septimus E, Okhuysen PC

A retrospective, comparative evaluation of dysglycemias in hospitalized patients receiving gatifloxacin, levofloxacin, ciprofloxacin, or ceftriaxone.

Pharmacotherapy. 2005 Oct;25(10):1303-9.

PubMed ID

16185173 [ View in PubMed

]

Abstract

STUDY OBJECTIVES: To compare rates of blood glucose abnormalities in hospitalized patients receiving fluoroquinolones or ceftriaxone, and to describe the characteristics of patients who develop blood glucose abnormalities while receiving these agents. DESIGN: Retrospective chart review. SETTING: Two community-based hospitals in the Houston, Texas, region. PATIENTS: Seventeen thousand one hundred eight patients who received fluoroquinolones or ceftriaxone; of those, 101 received levofloxacin, gatifloxacin, or ceftriaxone and also had serum glucose concentrations above 200 or below 50 mg/dl within 72 hours of receiving the drug. MEASUREMENTS AND MAIN RESULTS: Baseline demographics of patients with glucose abnormalities while receiving gatifloxacin, levofloxacin, or ceftriaxone were similar. Mean +/- SD patient age, weight, and estimated creatinine clearance were 67 +/- 17 years, 79 +/- 21 kg, and 52 +/- 32 ml/minute, respectively. Dysglycemia rates relative to treatment were as follows: gatifloxacin 76 (1.01%) of 7540 patients, levofloxacin 11 (0.93%) of 1179, ceftriaxone 14 (0.18%) of 7844, ciprofloxacin 0 (0%) of 545, and any fluoroquinolone 87 (0.94%) of 9264. Dysglycemia was more likely to occur in patients receiving any fluoroquinolone than in those receiving ceftriaxone (relative risk [RR] 3.32, 95% confidence interval (CI) 2.31-4.78, p < 0.05). The rate of dysglycemia did not differ with gatifloxacin and levofloxacin (RR 1.07, 95% CI 0.62-1.86, p = 0.8). Of the 101 patients with dysglycemias, hypoglycemia occurred in nine (9%) and hyperglycemia in 92 (91%). In a multivariate analysis of patients receiving fluoroquinolones, only concomitant sulfonylurea therapy was identified as an independent risk factor for development of hypoglycemia compared with patients who experienced hyperglycemia. CONCLUSION: In the 17,108 patients receiving a fluoroquinolone or ceftriaxone, the rate of dysglycemia was greater in those receiving levofloxacin or gatifloxacin than in those receiving ceftriaxone. However, no difference was noted in the rate of glucose abnormalities with levofloxacin versus gatifloxacin. Clinicians should be aware of dysglycemic events that may occur in patients receiving fluoroquinolones, especially in those with diabetes mellitus or those receiving sulfonylureas.

DrugBank Data that Cites this Article

Drug Interactions

Drugs	Interaction
Integrate drug-drug interactions in your software
Acarbose Moxifloxacin	The therapeutic efficacy of Acarbose can be increased when used in combination with Moxifloxacin.
Acarbose Grepafloxacin	The therapeutic efficacy of Acarbose can be increased when used in combination with Grepafloxacin.
Acarbose Enoxacin	The therapeutic efficacy of Acarbose can be increased when used in combination with Enoxacin.
Acarbose Pefloxacin	The therapeutic efficacy of Acarbose can be increased when used in combination with Pefloxacin.
Acarbose Ciprofloxacin	The therapeutic efficacy of Acarbose can be increased when used in combination with Ciprofloxacin.

Pharmaco-metabolomics

Drug	Drug Groups	Metabolite	Change	Description
Ceftriaxone	Approved	Glucose	decreased	Ceftriaxone decreases the level of Glucose in the blood
Ceftriaxone	Approved	Glucose	increased	Ceftriaxone increases the level of Glucose in the blood
Gatifloxacin	Approved Investigational Withdrawn	Glucose	increased	Gatifloxacin increases the level of Glucose in the blood
Levofloxacin	Approved Investigational	Glucose	increased	Levofloxacin increases the level of Glucose in the blood
Gatifloxacin	Approved Investigational Withdrawn	Glucose	decreased	Gatifloxacin decreases the level of Glucose in the blood
Levofloxacin	Approved Investigational	Glucose	decreased	Levofloxacin decreases the level of Glucose in the blood