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

The DOI matches its Crossref record; 45 of the 45 references it cites were found in a registry or an index.

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., Mamdani, Muhammad M.·2006·New England Journal of Medicine

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. 10.1345/aph.1A480 · DOI · Paper page
  2. Tailor SA, 2004, Can J Hosp Pharm, 57, 12
  3. Frothingham R. Gatifloxacin associated with a 56-fold higher rate of glucose homeostasis abnormalities than comparator quinolones in FDA Spontaneous Reporting Database. In: Program and abstracts of the 44th Interscience Conference on Antimicrobial Agents and Chemotherapy, Washington, D.C., October 30–November 2, 2004. Washington, D.C.: American Society for Microbiology, 2004:19.
  4. Letourneau G, 2003, Can Adverse React Newsl, 13, 1
  5. Grasela DM, Lacreta F, Kollia G, Randall D, Stoltz R, Berger S. Lack of effect of multiple-dose gatifloxacin (GAT) on oral glucose tolerance (OGTT), glucose and insulin homeostasis, and glyburide pharmacokinetics (PK) in patients with type II non-insulin-dependent diabetes mellitus (NIDDM). In: Program and abstracts of the 39th Interscience Conference on Antimicrobial Agents and Chemotherapy, San Francisco, September 26–29, 1999. Washington, D.C.: American Society for Microbiology, 1999:11.
  6. Schwarzbard L, Lodise TP, Lomaestro BM, Smith R. Comparison of glucose intolerance (GI) between gatifloxacin (G) and levofloxacin (L) in elderly, hospitalized patients. In: Program and abstracts of the 45th Interscience Conference on Antimicrobial Agents and Chemotherapy, Washington, D.C., December 16–19, 2005. Washington, D.C.: American Society for Microbiology, 2005:463.
  7. Levy AR, 2003, Can J Clin Pharmacol, 10, 67
  8. Mamdani MM, 2000, CMAJ, 162, 1421
  9. Assan R, 1993, Diabetes Metab, 19, 262

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Metadata

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)
Venue
New England Journal of Medicine
Published
2006-03-30
Volume
354
Issue
13
Pages
1352-1361
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2062975680
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 (medical) › Antibiotics Pharmacokinetics and Efficacy
  • Health Sciences › Medicine › Infectious Diseases › 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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