Hypoglycemia events associated with gatifloxacin and levofloxacin

Abstract

Purpose Hypoglycemic events have been reported with fluoroquinolone antibiotics. The odds of hypoglycemia after gatifloxacin and levofloxacin are unknown. Methods Unmatched, case‐control study of 85 in‐patients who received gatifloxacin or levofloxacin between November 2000 and November 2002 and had blood glucose less than 50 mg/dL. A random sample of controls (n=239) received gatifloxacin or levofloxacin during the same period without hypoglycemia. Logistic regression adjusted odds of hypoglycemia for significant covariates: renal failure, severity of illness, and hypoglycemic drug therapy. Results Unadjusted odds for exposure to gatifloxacin versus levofloxacin was 2.38 (95% CI 1.42 to 3.99) times higher for patients with low blood glucose than for controls. After adjustment for covariates, the adjusted odds for gatifloxacin versus levofloxacin was 2.02 (95% CI 1.08 to 3.79) times higher. Sensitivity analysis used a subset of 35 cases who displayed Whipple's hypoglycemic triad. Odds for gatifloxacin versus levofloxacin was 4.03 (95% CI 1.70 to 9.59) times higher in the subset cases. Conclusion When comparing gatifloxacin and levofloxacin, the odds of hypoglycemia are greater with gatifloxacin even after adjustment for other risk factors associated with hypoglycemia. Clinical Pharmacology & Therapeutics (2005) 77, P70–P70; doi: