Elsevier

Primary Care Diabetes

Volume 9, Issue 3, June 2015, Pages 168-171
Primary Care Diabetes

Review
Dysglycemia associated with quinolones

https://doi.org/10.1016/j.pcd.2014.10.006Get rights and content

Highlights

Abstract

Antimicrobial therapy is well known to be associated with fluctuations of blood glucose levels. This review aims at exploring the association between glycemic fluctuations and antibiotics mainly focusing on quinolones. Quinolones are associated with hypoglycemia and hyperglycemia. Several mechanism are proposed to explain this causality.

Introduction

Antimicrobial therapy is widely used as part of treatment of outpatient or inpatient infectious diseases. Whether through parenteral or enteral routes, antibiotics are well known to have a wide range of adverse events, namely blood glucose disturbances. In addition, severe infections can predispose patients to both hypoglycemia and hyperglycemia. Dysglycemic events were found to occur with several classes of antibiotic use and are not restricted to diabetic patients.

Section snippets

Methods

We searched Medline for literature published on fluoroquinolone-associated dysglycemia with no time limit starting 1946 until present. We used the following MESh to search separately for hyperglycemia and anti-bacterial agents, and hypoglycemia and anti-bacterial agents. The first search lead to 189 articles and the second to 207 articles. Screening and selection of the relevant articles narrowed the search to a total of 91 articles.

The fluoroquinolone antibiotics are widely used because they

Conclusion

Dysglycemia have been documented to occur in a wide range of antimicrobials. Most of which occurred with the use of quinolones. Several factors play an important role in the prediction of the occurrence and the degree of hypoglycemia or hyperglycemia. Therefore, it may be prudent to use them with caution in patients who are prone to hypoglycemia and hyperglycemic events, such as individuals with diabetes

Conflict of interest

The authors state that they have no conflict of interest.

References (22)

  • C. Yip et al.

    Gatifloxacin-induced hyperglycemia: a case report and summary of the current literature

    Clin. Ther.

    (2006)
  • R. Bhasin et al.

    Hypoglycemia associated with the use of gatifloxacin

    Am. J. Med. Sci.

    (2005)
  • W.S. Biggs

    Hypoglycemia and hyperglycemia associated with gatifloxacin use in elderly patients

    J. Am. Board Fam. Pract.

    (2003)
  • M. Catero

    Dysglycemia and fluoroquinolones: are you putting patients at risk?

    J. Fam. Pract.

    (2007)
  • R.J. Lewis et al.

    Dysglycaemias and fluoroquinolones

    Drug Saf.

    (2008)
  • S.L. Aspinall

    Severe dysglycemia with the fluoroquinolones: a class effect?

    Clin. Infect. Dis.

    (2009)
  • J.F. Mohr

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

    Pharmacotherapy

    (2005)
  • P.G. Talwalkar

    Gatifloxacin-induced severe hypoglycemia in a patient with type 2 diabetes mellitus

    J. Assoc. Physicians India

    (2006)
  • R. Frothingham

    Glucose homeostasis abnormalities associated with use of gatifloxacin

    Clin. Infect. Dis.

    (2005)
  • L.A. Beste et al.

    Hyperglycemia and gatifloxacin: a case report and summary of current literature

    Am. J. Geriatr. Pharmacother.

    (2005)
  • A.R. Donaldson et al.

    Possible gatifloxacin-induced hyperglycemia

    Ann. Pharmacother.

    (2004)
  • Cited by (21)

    • In vivo and in silico evaluations of survival and cardiac developmental toxicity of quinolone antibiotics in zebrafish embryos (Danio rerio)

      2021, Environmental Pollution
      Citation Excerpt :

      Considering the extensive use of quinolone antibiotics, the safety profiles of these drugs need to be carefully evaluated for avoiding the potential risks to human health and ecosystems (Ge et al., 2018; Riaz et al., 2018). In fact, several quinolones, including temafloxacin, gepafloxacin, trafloxacin, and sparfloxacin, have already been associated with severe adverse drug reactions (ADRs), such as hemolytic uremia (temafloxacin) (Maguire et al., 1994), hepatic effects (trovafloxacin) (Mitsugi et al., 2016), hypo- and hyperglycaemia (gatifloxacin) (El Ghandour and Azar, 2015), and QT interval (from the beginning of QRS complex to the end of T wave on the electrocardiogram) prolongation (sparfloxacin and grepafloxacin) (Pugi et al., 2012). Grepafloxacin (1999) and sparfloxacin (2001) were withdrawn from the market due to adverse cardiac reaction (Abo-Salem et al., 2014; Briasoulis et al., 2011).

    • Safety of fluoroquinolones

      2024, Revista Espanola de Quimioterapia
    View all citing articles on Scopus
    View full text