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Possible gatifloxacin-induced hyperglycemia
Amy R Donaldson1, Jeremy R Vandiver, Christopher K Finch
1Harrison School of Pharmacy, Auburn University, Auburn, AL, USA. donalar@auburn.edu
The Annals of Pharmacotherapy
|February 26, 2004
Summary
This case report details a non-diabetic woman who developed severe hyperglycemia after starting gatifloxacin. Blood glucose levels normalized after discontinuing the antibiotic, suggesting a drug-induced effect.
Area of Science:
- Pharmacology
- Endocrinology
- Infectious Diseases
Background:
- Gatifloxacin is a fluoroquinolone antibiotic with known, though infrequent, associations with glucose dysregulation.
- Hyperglycemia and hypoglycemia have been reported with gatifloxacin use, but the precise mechanisms remain unclear.
Observation:
- A 64-year-old woman with cardiovascular history presented with urosepsis and was treated with gatifloxacin.
- Within three days of gatifloxacin therapy, her blood glucose levels dramatically increased from 117 mg/dL to 607 mg/dL.
- Upon switching to cefazolin, her blood glucose levels gradually returned to normal.
Findings:
- The rapid onset and resolution of hyperglycemia following gatifloxacin administration and subsequent discontinuation strongly suggest an iatrogenic cause.
- The Naranjo probability scale indicated a possible drug-related event.
- This patient experienced a more rapid hyperglycemic response compared to previous case reports.
Implications:
- Clinicians should maintain a high index of suspicion for gatifloxacin-induced hyperglycemia, even in non-diabetic patients.
- Awareness of gatifloxacin's potential to alter blood glucose levels is crucial for safe patient management.
- Further research into the mechanisms underlying gatifloxacin's effects on glucose metabolism is warranted.