Severe Hyperglycemia During Renally Adjusted Gatifloxacin Therapy

Abstract

Healthcare professionals should be more aware of the possible development of hyperglycemia in all patients taking gatifloxacin, including those who are not diabetic and those receiving appropriately reduced doses for renal dysfunction.

Gatifloxacin Induces Augmented Insulin Release and Intracellular Insulin Depletion of Pancreatic Islet Cells

“…21) When using GFLX, dosage must be adjusted to suit the patients' renal function, and physicians and other medical staff should keep in mind the possibility of glycemic alteration and monitor blood glucose level carefully.…”

The insulinotropic effect of fluoroquinolones

“…Also, the fluoroquinolones norfloxacin and levofloxacin were found to be only weakly effective as K ATP channel blockers [10,11], but nevertheless there are case reports linking these compounds to severe and even lethal hypogycemias [13,14], which 4 raises the question as to whether there are unidentified triggering factors. Finally, gatifloxacin is also associated with the induction of hyperglycemic episodes in diabetic and non-diabetic patients [15,16]. The hyperglycemic episodes, which are even more frequent than the hypoglycemic episodes [1] are not easily explained by a block of K ATP channels [17].…”

An acute experimental study to evaluate the effect of gatifloxacin on blood sugar levels in diabetic and non-diabetic rabbits

“…7,[15][16][17] Hyperglycemia has been seen to occur more commonly after prolonged intake of the medication. 18 However, majority of these studies were retrospective, based on case records, and short of establishing any definite relationship between drug intake and blood glucose levels.…”

“…both hypo as well as hyperglycemia in elderly patients. 2,5,[15][16][17] However, definitive reports on this adverse effect of gatifloxacin are still lacking. This study was done to evaluate if dysglycemic effects were exerted by gatifloxacin and whether this could have a deleterious effect, especially in diabetic patients, on concurrent oral hypoglycemic agents.…”