Taking fluoroquinolones, a class of antibiotics commonly used to treat pneumonia and urinary tract infections, may increase the risk of blood sugar disturbances in individuals with diabetes, according to a study published today in the journal Clinical Infectious Diseases.
Previous studies have linked the use of fluoroquinolones with an increased risk of tendon rupture or cardiac disturbances in the general population. Some case reports and studies have suggested that these antibiotics may also disrupt blood sugar control in individuals with diabetes. The new study looked at a large national sample and was able to provide a better sense of the frequency of such blood sugar control problems and which antibiotics appear to pose the greatest risk for people with diabetes.
The study examined medical records for 78 433 patients in Taiwan who had diabetes and were receiving antibiotics and compared the risk of an emergency department visit or hospitalization for hypoglycemia (low blood sugar levels) or hyperglycemia (high blood sugar levels) within 30 days of taking certain antibiotics. The researchers found that patients with diabetes who had taken fluoroquinolone antibiotics had higher rates of both hyperglycemia and hypoglycemia compared with those who had taken macrolide antibiotics.
The fluoroquinolone moxifloxacin in particular was associated with higher rates of these adverse events, with 6.9 cases of hyperglycemia occurring for every 1000 people with diabetes taking the drug compared with 1.6 cases per 1000 individuals with diabetes taking a macrolide antibiotic. Rates of hyperglycemic events were also elevated for levofloxacin, at 3.9 cases per 1000, and for ciprofloxacin, at about 4 cases per 1000.
The risk of hypoglycemia was also elevated in individuals with diabetes taking fluoroquinolones, with 10 cases per 1000 individuals taking moxifloxacin, 9.3 per 1000 for those taking levofloxacin, and 7.9 per 1000 for those taking ciprofloxacin, compared with only 3.7 cases per 1000 taking macrolides.
For perspective, the authors pointed out in a statement that their findings translate to at most only 1 hospitalization or emergency department visit for every 100 individuals with diabetes who take a fluoroquinolone. However, they added, physicians may want to consider these risks when selecting an antibiotic for an individual with diabetes.