https://scholars.lib.ntu.edu.tw/handle/123456789/517152
Title: | Risk of severe dysglycemia among diabetic patients receiving levofloxacin, ciprofloxacin, or moxifloxacin in Taiwan | Authors: | Chou H.-W. Wang J.-L. CHIA-HSUIN CHANG Lee J.-J. Shau W.-Y. Lai M.-S. |
Issue Date: | 2013 | Journal Volume: | 57 | Journal Issue: | 7 | Start page/Pages: | 971-980 | Source: | Clinical Infectious Diseases | Abstract: | Background. Observational studies and fatal case reports raise concern about the safety of severe dysglycemia associated with fluoroquinolone use. The objective of this study was to assess the risk of severe dysglycemia among diabetic patients who received different fluoroquinolones. Methods. In a population-based inception cohort study of diabetic patients covering the period from January 2006 to November 2007, outpatient new users of levofloxacin, ciprofloxacin, moxifloxacin, cephalosporins, and macrolides orally were identified. Study events were defined as emergency department visits or hospitalization for dysglycemia within 30 days following the initiation of antibiotic therapy. Results were analyzed with adjusted multinomial propensity score. Results. A total of 78 433 diabetic patients receiving the antibiotics of interest were included in the study. The absolute risk of hyperglycemia per 1000 persons was 6.9 for moxifloxacin and 1.6 for macrolides. In contrast, the risk of hypoglycemia was 10.0 for moxifloxacin and 3.7 for macrolides. The adjusted odds ratios (AORs) and 95% confidence intervals (CIs) of levofloxacin, ciprofloxacin, and moxifloxacin compared with macrolides were 1.75 (1.12-2.73), 1.87 (1.20-2.93), and 2.48 (1.50-4.12), respectively, for hyperglycemia and 1.79 (1.33-2.42), 1.46 (1.07- 2.00), and 2.13 (1.44-3.14), respectively, for hypoglycemia. Patients taking moxifloxacin faced a significantly higher risk of hypoglycemia than those receiving ciprofloxacin. A significant increase in the risk of hypoglycemia was also observed among patients receiving moxifloxacin concomitantly with insulin (AOR, 2.28; 95% CI, 1.22-4.24). Conclusions. Diabetics using oral fluoroquinolones faced greater risk of severe dysglycemia. The risk of hypoglycemia varied according to the type of fluoroquinolone administered, and was most commonly associated with moxifloxacin. ? The Author 2013. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84884364269&doi=10.1093%2fcid%2fcit439&partnerID=40&md5=46de1e7ce3a14ed664a3388f04bedca4 https://scholars.lib.ntu.edu.tw/handle/123456789/517152 |
ISSN: | 1058-4838 | DOI: | 10.1093/cid/cit439 | SDG/Keyword: | cephalosporin derivative; ciprofloxacin; insulin; levofloxacin; macrolide; moxifloxacin; adult; antibiotic therapy; article; cohort analysis; diabetes mellitus; diabetic patient; disease severity; dysglycemia; female; high risk patient; human; hyperglycemia; hypoglycemia; incidence; major clinical study; male; priority journal; risk assessment; Taiwan; cohort study; diabetes mellitus; fluoroquinolones; hyperglycemia; hypoglycemia; Aged; Aged, 80 and over; Anti-Bacterial Agents; Aza Compounds; Ciprofloxacin; Cohort Studies; Diabetes Complications; Female; Fluoroquinolones; Humans; Hyperglycemia; Hypoglycemia; Levofloxacin; Male; Middle Aged; Odds Ratio; Propensity Score; Quinolines; Taiwan |
Appears in Collections: | 醫學系 |
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