Tags

Type your tag names separated by a space and hit enter

Prevalence of and risk factors for dysglycemia in patients receiving gatifloxacin and levofloxacin in an outpatient setting.
Pharmacotherapy. 2008 Jan; 28(1):82-9.P

Abstract

STUDY OBJECTIVES

To assess the prevalence of dysglycemia (hypoglycemia or hyperglycemia) associated with oral levofloxacin and gatifloxacin therapy in an outpatient setting, and to determine the characteristics of patients who developed dysglycemia while receiving either fluoroquinolone.

DESIGN

Retrospective medical record review.

SETTING

Outpatient clinic of a Veterans Affairs teaching hospital.

PATIENTS

A total of 1573 patients who received oral levofloxacin (343 patients), gatifloxacin (589 patients), or azithromycin (as a control, 641 patients) between June 1, 2004, and May 31, 2006.

MEASUREMENTS AND MAIN RESULTS

Dysglycemia occurred in 33 patients: 13 (2.2%), 9 (2.6%), and 11 (1.7%), respectively, of those in the gatifloxacin, levofloxacin, and azithromycin groups. Of 13 patients who experienced a hyperglycemic event, 11 (84.6%) had diabetes mellitus. After adjustment for confounding factors, neither levofloxacin nor gatifloxacin were associated with increased odds of developing a dysglycemic event compared with azithromycin. Multivariate analysis demonstrated that lack of downward dosage adjustment based on creatinine clearance (odds ratio [OR] 10.3, 95% confidence interval [CI] 3.8-27.6), presence of diabetes (OR 17.1, 95% CI 3.1-94.9), or treatment with insulin (OR 5.3, 95% CI 1.8-15.7) or sulfonylureas (OR 3.6, 95% CI 1.3-10.4) independently increased dysglycemia risk. Obesity (body mass index > or = 30 kg/m(2)) was independently protective (OR 0.22, 95% CI 0.09-0.55) against dysglycemic events.

CONCLUSION

Levofloxacin and gatifloxacin were not significantly associated with increased dysglycemic events compared with azithromycin. Lack of downward fluoroquinolone dosage adjustment for renal function, presence of diabetes, and treatment with insulin or sulfonylureas each independently increased the risk of dysglycemia. Obesity was independently protective against dysglycemia. More data are needed on the contributing effects of diabetes, fluoroquinolone dosage, and concomitant drug therapy so that an appropriate risk-management strategy can be developed.

Authors+Show Affiliations

Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Providence, Rhode Island, USA. KerryTedesco@uri.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18154478

Citation

LaPlante, Kerry L., et al. "Prevalence of and Risk Factors for Dysglycemia in Patients Receiving Gatifloxacin and Levofloxacin in an Outpatient Setting." Pharmacotherapy, vol. 28, no. 1, 2008, pp. 82-9.
LaPlante KL, Mersfelder TL, Ward KE, et al. Prevalence of and risk factors for dysglycemia in patients receiving gatifloxacin and levofloxacin in an outpatient setting. Pharmacotherapy. 2008;28(1):82-9.
LaPlante, K. L., Mersfelder, T. L., Ward, K. E., & Quilliam, B. J. (2008). Prevalence of and risk factors for dysglycemia in patients receiving gatifloxacin and levofloxacin in an outpatient setting. Pharmacotherapy, 28(1), 82-9.
LaPlante KL, et al. Prevalence of and Risk Factors for Dysglycemia in Patients Receiving Gatifloxacin and Levofloxacin in an Outpatient Setting. Pharmacotherapy. 2008;28(1):82-9. PubMed PMID: 18154478.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of and risk factors for dysglycemia in patients receiving gatifloxacin and levofloxacin in an outpatient setting. AU - LaPlante,Kerry L, AU - Mersfelder,Tracey L, AU - Ward,Kristina E, AU - Quilliam,Brian J, PY - 2007/12/25/pubmed PY - 2008/5/6/medline PY - 2007/12/25/entrez SP - 82 EP - 9 JF - Pharmacotherapy JO - Pharmacotherapy VL - 28 IS - 1 N2 - STUDY OBJECTIVES: To assess the prevalence of dysglycemia (hypoglycemia or hyperglycemia) associated with oral levofloxacin and gatifloxacin therapy in an outpatient setting, and to determine the characteristics of patients who developed dysglycemia while receiving either fluoroquinolone. DESIGN: Retrospective medical record review. SETTING: Outpatient clinic of a Veterans Affairs teaching hospital. PATIENTS: A total of 1573 patients who received oral levofloxacin (343 patients), gatifloxacin (589 patients), or azithromycin (as a control, 641 patients) between June 1, 2004, and May 31, 2006. MEASUREMENTS AND MAIN RESULTS: Dysglycemia occurred in 33 patients: 13 (2.2%), 9 (2.6%), and 11 (1.7%), respectively, of those in the gatifloxacin, levofloxacin, and azithromycin groups. Of 13 patients who experienced a hyperglycemic event, 11 (84.6%) had diabetes mellitus. After adjustment for confounding factors, neither levofloxacin nor gatifloxacin were associated with increased odds of developing a dysglycemic event compared with azithromycin. Multivariate analysis demonstrated that lack of downward dosage adjustment based on creatinine clearance (odds ratio [OR] 10.3, 95% confidence interval [CI] 3.8-27.6), presence of diabetes (OR 17.1, 95% CI 3.1-94.9), or treatment with insulin (OR 5.3, 95% CI 1.8-15.7) or sulfonylureas (OR 3.6, 95% CI 1.3-10.4) independently increased dysglycemia risk. Obesity (body mass index > or = 30 kg/m(2)) was independently protective (OR 0.22, 95% CI 0.09-0.55) against dysglycemic events. CONCLUSION: Levofloxacin and gatifloxacin were not significantly associated with increased dysglycemic events compared with azithromycin. Lack of downward fluoroquinolone dosage adjustment for renal function, presence of diabetes, and treatment with insulin or sulfonylureas each independently increased the risk of dysglycemia. Obesity was independently protective against dysglycemia. More data are needed on the contributing effects of diabetes, fluoroquinolone dosage, and concomitant drug therapy so that an appropriate risk-management strategy can be developed. SN - 0277-0008 UR - https://www.unboundmedicine.com/medline/citation/18154478/Prevalence_of_and_risk_factors_for_dysglycemia_in_patients_receiving_gatifloxacin_and_levofloxacin_in_an_outpatient_setting_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=18154478.ui DB - PRIME DP - Unbound Medicine ER -