Possible gatifloxacin-induced hyperglycemia.
OBJECTIVE
To report a case of possible gatifloxacin-induced hyperglycemia in a nondiabetic middle-aged woman.


METHODS
A 64-year-old Indian woman with an extensive cardiovascular history was admitted for urosepsis. On admission, her blood glucose was 117 mg/dL. She was empirically started on gatifloxacin 400 mg/day; after 3 days of gatifloxacin therapy, her blood glucose was 607 mg/dL. On day 4, therapy was changed to cefazolin for sensitive Escherichia coli and her blood glucose levels began to return to normal.


CONCLUSIONS
Although gatifloxacin has been previously reported as a potential cause of both hyper- and hypoglycemia, the exact mechanism is unknown. Several factors that may have been involved in our patient's hyperglycemia are discussed. She experienced hyperglycemic changes more rapidly than did the typical patients of previous reports. The Naranjo probability scale suggests a possible drug-related event.


CONCLUSIONS
The temporal relationship between gatifloxacin administration and the patient's hyperglycemia suggests an iatrogenic cause. Based on our experience and the product labeling, clinicians should be more aware of the blood glucose-altering effects of gatifloxacin.
Harrison School of Pharmacy, Auburn University, Auburn, AL, USA. donalar@auburn.edu
Amy R
AR
Donaldson
Jeremy R
JR
Vandiver
Christopher K
CK
Finch
D000892:Anti-Infective Agents, Urinary / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D024841:Fluoroquinolones / Q000009:adverse effects* / Q000627:therapeutic use; D000077734:Gatifloxacin; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced*; D008875:Middle Aged; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000188:drug therapy
D000892:Anti-Infective Agents, Urinary; D024841:Fluoroquinolones; D000077734:Gatifloxacin