Gatifloxacin Therapy Associated with Hypoglycemia

Abstract

SIR—Sporadic published case reports [1, 2] and anecdotal reports to the US Food and Drug Administration MedWatch system have linked administration of fluoroquinolone antibiotics (FQAs), in particular gatifloxacin, with early-onset hypoglycemia in patients with diabetes. Most reported patients were aged ⩾65 years and were concomitantly receiving a sulfonyurea class drug. FQAs have been demonstrated to augment insulin release in a dose-dependent manner from isolated pancreatic islet cells [3] and to increase insulin levels in patients with type 2 diabetes mellitus who are not receiving medication [4], actions similar to those of sulfonyureas. In consideration of the data indicating that the background rate of hypoglycemia in sick elderly persons who require hospital admission may be ∼5% [5], we examined whether gatifloxacin therapy is associated with a higher incidence of hypoglycemia than therapy with non-FQA drugs in this group of patients.