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Glucose homeostasis abnormalities associated with use of gatifloxacin.
Clin Infect Dis. 2005 Nov 01; 41(9):1269-76.CI

Abstract

BACKGROUND

More than 20 published case reports have described an association between the use of gatifloxacin and hypoglycemia or hyperglycemia. We compare the rates of glucose homeostasis abnormality (GHA) adverse event reports (AERs) associated with the use of gatifloxacin and comparator quinolones.

METHODS

We obtained spontaneous AERs associated with the use of ciprofloxacin, gatifloxacin, levofloxacin, and moxifloxacin from the US Food and Drug Administration that were reported between November 1997 and September 2003. We removed duplicate and foreign cases. We used specific coding terms to identify GHA AERs. We calculated GHA AER rates, using either the total number of AERs or estimated retail prescriptions as denominators.

RESULTS

The use of ciprofloxacin, gatifloxacin, levofloxacin, and moxifloxacin was associated with 10,025 unique AERs in the United States, including 568 GHA AERs, 25 of which had fatality. Use of gatifloxacin was associated with 453 GHA AERs (80%) and 17 GHA AERs with fatality (68%). GHA AERs comprised 24% of all AERs associated with gatifloxacin, compared with ciprofloxacin (1.3%), levofloxacin (1.6%), and moxifloxacin (1.3%) (P<.0001 for each comparison). Use of gatifloxacin was associated with 477 GHA AERs per 10(7) retail prescriptions, compared with ciprofloxacin (4 GHA AERs), levofloxacin (11 GHA AERs), and moxifloxacin (39 GHA AERs) (P<.0001 for each comparison). Patients with GHA AERs were older and more likely to be receiving concomitant treatment for diabetes. Limitations of the study include the use of spontaneous adverse event reporting, which is incomplete and potentially biased. This analysis cannot be used alone to demonstrate causality.

CONCLUSIONS

Use of gatifloxacin is associated with a much higher rate of GHA AERs than are comparator quinolones. This analysis is consistent with the results of in vitro analyses, animal studies, human volunteer studies, case reports, and a large randomized trial. Alternatives to gatifloxacin should be used in patients with diabetes.

Authors+Show Affiliations

Veterans Affairs Medical Center, Durham, NC, USA. richard.frothingham@duke.edu

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

16206101

Citation

Frothingham, Richard. "Glucose Homeostasis Abnormalities Associated With Use of Gatifloxacin." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 41, no. 9, 2005, pp. 1269-76.
Frothingham R. Glucose homeostasis abnormalities associated with use of gatifloxacin. Clin Infect Dis. 2005;41(9):1269-76.
Frothingham, R. (2005). Glucose homeostasis abnormalities associated with use of gatifloxacin. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 41(9), 1269-76.
Frothingham R. Glucose Homeostasis Abnormalities Associated With Use of Gatifloxacin. Clin Infect Dis. 2005 Nov 1;41(9):1269-76. PubMed PMID: 16206101.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glucose homeostasis abnormalities associated with use of gatifloxacin. A1 - Frothingham,Richard, Y1 - 2005/09/28/ PY - 2005/05/15/received PY - 2005/07/06/accepted PY - 2005/10/6/pubmed PY - 2006/7/14/medline PY - 2005/10/6/entrez SP - 1269 EP - 76 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 41 IS - 9 N2 - BACKGROUND: More than 20 published case reports have described an association between the use of gatifloxacin and hypoglycemia or hyperglycemia. We compare the rates of glucose homeostasis abnormality (GHA) adverse event reports (AERs) associated with the use of gatifloxacin and comparator quinolones. METHODS: We obtained spontaneous AERs associated with the use of ciprofloxacin, gatifloxacin, levofloxacin, and moxifloxacin from the US Food and Drug Administration that were reported between November 1997 and September 2003. We removed duplicate and foreign cases. We used specific coding terms to identify GHA AERs. We calculated GHA AER rates, using either the total number of AERs or estimated retail prescriptions as denominators. RESULTS: The use of ciprofloxacin, gatifloxacin, levofloxacin, and moxifloxacin was associated with 10,025 unique AERs in the United States, including 568 GHA AERs, 25 of which had fatality. Use of gatifloxacin was associated with 453 GHA AERs (80%) and 17 GHA AERs with fatality (68%). GHA AERs comprised 24% of all AERs associated with gatifloxacin, compared with ciprofloxacin (1.3%), levofloxacin (1.6%), and moxifloxacin (1.3%) (P<.0001 for each comparison). Use of gatifloxacin was associated with 477 GHA AERs per 10(7) retail prescriptions, compared with ciprofloxacin (4 GHA AERs), levofloxacin (11 GHA AERs), and moxifloxacin (39 GHA AERs) (P<.0001 for each comparison). Patients with GHA AERs were older and more likely to be receiving concomitant treatment for diabetes. Limitations of the study include the use of spontaneous adverse event reporting, which is incomplete and potentially biased. This analysis cannot be used alone to demonstrate causality. CONCLUSIONS: Use of gatifloxacin is associated with a much higher rate of GHA AERs than are comparator quinolones. This analysis is consistent with the results of in vitro analyses, animal studies, human volunteer studies, case reports, and a large randomized trial. Alternatives to gatifloxacin should be used in patients with diabetes. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/16206101/Glucose_homeostasis_abnormalities_associated_with_use_of_gatifloxacin_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/496929 DB - PRIME DP - Unbound Medicine ER -