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Hypoglycemia, Hyperglycemia, and Gatifloxacin

Weerapan Khovidhunkit, MD, PhD; and Sarat Sunthornyothin, MD
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From Chulalongkorn University, Bangkok, Thailand 10330.

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Ann Intern Med. 2004;141(12):969. doi:10.7326/0003-4819-141-12-200412210-00022
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Disturbances in Blood Glucose With Fluoroquinolones
Posted on January 8, 2005
Anil K Gollapudi
VA Medical Center, Wilkes-Barre, PA
Conflict of Interest: None Declared

Recent case reports(1,2), animal studies (3,4,5), and the listing of blood glucose disturbances under the "warnings" section of the prescribing information for gatifloxacin, but not for other fluroquinolones(5)suggest that life threatening hypo and hyperglycemia may be more frequently associated with gatifloxacin than with other quinolones. Information regarding the incidence of life threatening hypo & hyperglycemia associated with different quinolones can be helpful to the prescribers in choosing appropriate antibiotics.

As drug administration history and blood glucose levels are available electronically for patients in several hospitals, obtaining and analyzing data regarding the incidence of blood glucose disturbances associated with different quinolones may be relatively easy and may prove to be a cost effective way to strengthen the FDA's postmarketing drug safety surveillance program.


1. Khovidhunkit W, Sunthornyothin S. Hypoglycemia, Hyperglycemia, and Gatifloxacin. Ann Intern Med. 2004; 141:969.

2. Happe MR et al. Gatifloxacin-induced hyperglycemia. Ann Intern Med. 2004; 141:968-969.

3. Gavin JR 3rd et al. Moxifloxacin and glucose homeostasis: a pooled -analysis of the evidence from clinical and postmarketing studies. Drug Saf. 2004; 27(9):671-86.

4. Saraya A et al. Effects of fluoroquinolones on insulin secretion and beta-cell ATP-sensitive K+ channels. Eur J Pharmacol. 2004; 497(1):111 -7.

5. PDR 2005.

Conflict of Interest:

None declared

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