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Fluoroquinolones Increase Risk for Severe Dysglycemia in Diabetes

Aug 28, 2013

Patients with diabetes who are taking fluoroquinolones are at a higher risk for uncontrolled blood glucose levels than those without the disease…. 

Researchers scrutinized data from 78,433 outpatients with diabetes (mostly type 2) who received a new prescription for a fluoroquinolone, a cephalosporin, and/or a macrolide between January 2006 and November 2007. Fluoroquinolones analyzed in the study included levofloxacin, ciprofloxacin, and moxifloxacin. To see if any of the antibiotics negatively affected the patients, "study events" were looked at and defined as "emergency department visits or hospitalization for dysglycemia within 30 days following the initiation of antibiotic therapy."

For every group consisting of 1,000 people, a significantly higher risk for hyperglycemia existed in patients who took moxifloxacin (abs. risk ~ 6.9) compared to those who took a macrolide (abs. risk~1.6). The risk of hypoglycemia was also higher in individuals who took moxifloxacin (abs. risk~10) over a macrolide (abs. risk 3.7). Overall, patients with diabetes faced a greater risk of uncontrolled glucose levels when taking fluoroquinolones than when taking any other antibiotic from a different class.

Among the fluoroquinolones, moxifloxacin was associated with a significantly higher risk of low blood glucose levels compared to ciprofloxacin. This risk was also seen when diabetes patients were taking moxifloxacin with insulin and when they presented with comorbid kidney disease.

The authors concluded, that while the risk is low, fluoroquinolones do have the potential of causing severe dysglycemia in patients with diabetes. They recommend that health care providers cautiously consider the risks when prescribing diabetic patients with this class of medications.

Chou HW et al. Risk of Severe Dysglycemia Among Diabetic Patients Receiving Levofloxacin, Ciprofloxacin, or Moxifloxacin in Taiwan. Clinical Infectious Diseases.2013; 57(5). Abstract.