Gatifloxacin produces both hypoglycemia and hyperglycemia: a retrospective study.
BACKGROUND
Gatifloxacin, until recently one of the most commonly prescribed antibiotics, has been shown to produce hypoglycemia.


METHODS
To further examine the effects of Gatifloxicin (G) on blood glucose (BS), we conducted a retrospective chart review on 264 inpatients, examining for both hypoglycemia and hyperglycemia, comparing G with another quinolone, Ciproflaxin (C), and nonquinolone, Ceftriaxone (R).


RESULTS
We found that of 292 patient encounters, 28 hypoglycemia and 48 hyperglycemic events occurred. Patients given G were 5 times as likely to become hypoglycemic as C (P < 0.01) and 9 times as likely as those given R (P < 0.02). Patients given G were 5.6 times more likely to develop hypoglycemia (P < 0.001) than the combined group, R+C. Conversely, patients treated with G were 3.8 times as likely to become hyperglycemic as those give C (P < 0.01) and 9.8 times as those given R (P < 0.01). With C and R combined, those given G were 5.2 times as likely to develop hyperglycemia (P < 0.01). Looking at patient encounters where G was given, we found that having preexisting diabetes mellitus (DM) was positively associated with hypoglycemia (21/144, P < 0.001). Steroid use (P < 0.05) and being in the ICU (P < 0.01) were also positively associated with hyperglycemia (38/144, P < 0.01).


CONCLUSIONS
In summary, G was clearly associated with both hypoglycemia and hyperglycemia compared with C and R. The risk of hyperglycemia increased in the presence of DM, steroid use, and "sick enough" to be in the intensive care unit.
Haerian
Haleh
H
Medical and Pharmacy Services, VAMC Memphis, Memphis, Tennessee 38104, USA.
McHugh
Peter
P
Brown
Richard
R
Somes
Grant
G
Solomon
Solomon S
SS
D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D005260:Female; D024841:Fluoroquinolones / Q000009:adverse effects*; D000077734:Gatifloxacin; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced* / Q000453:epidemiology*; D007003:Hypoglycemia / Q000139:chemically induced* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D000077734:Gatifloxacin