Compared with amoxicillin use, fluoroquinolone use didn't appear to increase the risk for severe hypoglycemia in older patients with diabetes on second-generation sulfonylureas.
The use of fluoroquinolones, a highly effective drug for the treatment of several bacterial infections, has raised safety concerns because of reports of various adverse effects , including hypoglycemia.
Researchers assembled a cohort of patients with diabetes who initiated second-generation sulfonylureas and assessed the 30-day risk for hypoglycemia in 143,417 patients who also initiated fluoroquinolones or amoxicillin. To assess the risk for severe hypoglycemia, fluoroquinolone users were matched up to 1:5 with amoxicillin users on number of previous sulfonylurea prescriptions, other antibiotic use in past month, and propensity scores.
The 30-day risk for severe hypoglycemia associated with fluoroquinolone use was assessed and compared with that associated with amoxicillin use.Overall, there was no statistically significant difference in the risk for severe hypoglycemia among those who initiated fluoroquinolones or amoxicillin while being on a second-generation sulfonylurea .
Stratified by age, fluoroquinolone vs amoxicillin use was associated with an increased risk for severe hypoglycemia in patients aged < 65 years but not in those aged ≥ 65 years."While our study findings should provide some reassurance to physicians and patients on second-generation sulfonylureas regarding the hypoglycemic safety of fluoroquinolones in advanced age, these antibiotics should be prescribed with caution when it comes to younger sulfonylurea users," the authors wrote.
Hypoglycemia Sulfonylureas Sulphonylureas Diabetes Mellitus Type 2 Diabetes Mellitus Type Ii Type 2 Diabetes Type 2 DM T2DM T2D Antibiotics Young Adult Hemoglobin A1c Hemoglobin A1c Test Glycated Hemoglobin Glycosylated Hemoglobin Hba1c A1C Hb1c Glycohemoglobin Ghb Diabetic Control Index A1C Assay Adverse Effects Side Effects Bacteria Bacterial Infection
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