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Cited by 367Pharmacovigilance and Adverse Drug ReactionsAntibiotics Pharmacokinetics and EfficacyAntibiotic Use and Resistance

Outpatient gatifloxacin therapy and dysglycemia in older adults.

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Park-Wyllie, Laura Y., Juurlink, David N., Kopp, Alexander, Shah, Baiju R., Stukel, Therese A., Stumpo, Carmine, Dresser, Linda, Low, Donald E. +1 more·2006·New England Journal of Medicine
DOI 10.1056/nejmoa055191
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Abstract

BACKGROUND: Gatifloxacin has been associated with both hypoglycemia and hyperglycemia. We examined dysglycemia-related health outcomes associated with various antibiotics in a population of approximately 1.4 million Ontario, Canada, residents 66 years of age or older. METHODS: We conducted two population-based, nested case-control studies. In the first, case patients were persons treated in the hospital for hypoglycemia after outpatient treatment with a macrolide, a second-generation cephalosporin, or a respiratory fluoroquinolone (gatifloxacin, levofloxacin, moxifloxacin, or ciprofloxacin). In the second, case patients were persons who received hospital care for hyperglycemia. For each case patient, we identified up to five controls matched according to age, sex, the presence or absence of diabetes, and the timing of antibiotic therapy. RESULTS: Between April 2002 and March 2004, we identified 788 patients treated for hypoglycemia within 30 days after antibiotic therapy. As compared with macrolide antibiotics, gatifloxacin was associated with an increased risk of hypoglycemia (adjusted odds ratio, 4.3; 95 percent confidence interval, 2.9 to 6.3). Levofloxacin was also associated with a slightly increased risk (adjusted odds ratio, 1.5; 95 percent confidence interval, 1.2 to 2.0), but no such risk was seen with moxifloxacin, ciprofloxacin, or cephalosporins. We then identified 470 patients treated for hyperglycemia within 30 days after antibiotic therapy. As compared with macrolides, gatifloxacin was associated with a considerably increased risk of hyperglycemia (adjusted odds ratio, 16.7; 95 percent confidence interval, 10.4 to 26.8), but no risk was noted with the other antibiotics. Risks were similar in the two studies regardless of the presence or absence of diabetes. CONCLUSIONS: As compared with the use of other broad-spectrum oral antibiotics, including other fluoroquinolones, the use of gatifloxacin among outpatients is associated with an increased risk of in-hospital treatment for both hypoglycemia and hyperglycemia.

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  1. [5]5. Baker SE, Hangii MC. Possible gati- floxacin-induced hypoglycemia. Ann Phar- macother 2002;36:1722-6.
  2. [8]8. Frothingham R. Gatifloxacin associ- ated with a 56-fold higher rate of glucose homeostasis abnormalities than compar- ator quinolones in FDA Spontaneous Re- porting Database. In: Program and ab- stracts of the 44th Interscience Conference on Antimicrobial Agents and Chemother- apy, Washington, D.C., October 30-Novem- ber 2, 2004.
  3. [10]10. Greenberg AL, Decerbo M, Fan J. Gat- ifloxacin therapy associated with hypo- glycemia. Clin Infect Dis 2005;40:1210-1.
  4. [12]12. Hypoglycemia, hyperglycemia, and gati- floxacin. Ann Intern Med 2004;141:969.
  5. [14]14. Létourneau G, Morrison H, McMor- ran M. Gatifloxacin: hypoglycemia and hyperglycemia. Can Adverse React Newsl 2003;13(3):1-2.
  6. [17]17. Bhatia V, Bhatia R, Dhindsa S. Gati- floxacin-induced hyperglycemia. Endocr Pract 2004;10:86. Tequin (gatifloxacin). Princeton, N.J.: Bristol-Myers Squibb, 2004 (package in- sert).
  7. [19]19. Cannon CP, Braunwald E, McCabe CH, et al. Antibiotic treatment of Chlamydia pneumoniae after acute coronary syndrome. N Engl J Med 2005;352:1646-54.
  8. [27]27. Grasela DM, Lacreta F, Kollia G, Ran- dall D, Stoltz R, Berger S. Lack of effect of multiple-dose gatifloxacin (GAT) on oral glucose tolerance (OGTT), glucose and insulin homeostasis, and glyburide phar- macokinetics (PK) in patients with type II non-insulin-dependent diabetes mellitus (NIDDM). In: Program and abstracts of the 39th Interscience Conference on Anti- microbial Agents and Chemotherapy, San Francisco, September 26-29, 1999.
  9. [30]30. Schwarzbard L, Lodise TP, Lomaestro BM, Smith R. Comparison of glucose in- tolerance (GI) between gatifloxacin (G) and levofloxacin (L) in elderly, hospital- ized patients. In: Program and abstracts of the 45th Interscience Conference on Antimicrobial Agents and Chemotherapy, Washington, D.C., December 16-19, 2005.
  10. [35]35. The New England Journal of Medicine Downloaded from nejm.org on August 30, 2023. For personal use only. No other uses without permission. Copyright © 2006 Massachusetts Medical Society. All rights reserved. Statistics Canada. Population by sex and age group, by province and territory. 2005. (Accessed March 6, 2006, at http:// www40.statcan.ca/l01/cst01/demo31a. htm.
  11. [46]46. Schneeweiss S, Maclure M. Use of co- morbidity scores for control of confound- ing in studies using administrative data- bases. Int J Epidemiol 2000;29:891-8.
  12. [48]48. claims data. Am J Epidemiol 2001;154: 854-64.
  13. [51]51. Altman DG, Bland JM. Interaction re- visited: the difference between two esti- mates. BMJ 2003;326:219. Center for Drug Evaluation and Re- view, Office of Drug Safety. Medical prod- uct safety information. (Accessed March 6, 2006, at http://www.fda.gov/medwatch/ safety.htm.)

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Authors
Park-Wyllie, L. Y., Juurlink, D. N., Kopp, A., Shah, B. R., Stukel, T. A., Stumpo, C., Dresser, L., Low, D. E., & Mamdani, M. M.
Affiliations
  • Sunnybrook Health Science Centre (CA)
  • University of Toronto (CA)
  • Toronto East General Hospital (CA)
  • Mount Sinai Hospital (CA)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2006-03-30
Volume
354
Issue
13
Pages
1352-1361
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa055191
OpenAlex
W2062975680
Semantic Scholar
f0f183514d6ec6dd63ab70a6c34984dd7e931846
Cited by
367
References
45
Citations by year
2026: 3 · 2025: 2 · 2024: 8 · 2023: 4 · 2022: 9 · 2021: 9 · 2020: 9 · 2019: 13 · 2018: 19 · 2017: 8 · 2016: 19 · 2015: 18 · 2014: 16 · 2013: 25 · 2012: 23
FWCI
51.98
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • TSpace (University of Toronto) (submittedVersion)
Topics
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
  • Health Sciences › Medicine › Pharmacology › Antibiotics Pharmacokinetics and Efficacy
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
Keywords
gatifloxacin, dysglycemia, hypoglycemia, hyperglycemia, fluoroquinolones, older adults, outpatient antibiotic therapy, macrolides, cephalosporins, levofloxacin, moxifloxacin, ciprofloxacin, adverse drug reactions, diabetes mellitus
MeSH terms
Gatifloxacin, Aged, Aged, 80 and over, Ambulatory Care, Anti-Bacterial Agents, Cephalosporins, Female, Hospitalization, Humans, Hyperglycemia, Hypoglycemia, Male, Ontario, Risk, Ofloxacin, Case-Control Studies, Macrolides, Fluoroquinolones, Diabetes Complications, Levofloxacin

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