Severe hyperglycemia during gatifloxacin therapy in patients without diabetes.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
Francis Clifford A ArceRoseMarie Pasmantier

Abstract

To present two cases of severe hyperglycemia in patients without diabetes who received gatifloxacin therapy. We describe the histories, clinical findings, and hospital courses of two women in whom severe hyperglycemia developed after gatifloxacin therapy was initiated. Interacting factors that may result in severe hyperglycemia in patients without diabetes and the literature explaining the mechanism by which gatifloxacin can alter glucose metabolism are reviewed. Our first patient, a 46-year-old woman with end-stage renal disease, presented with a 3-day history of fever, abdominal pain, and hypotension. Admission laboratory data included a fasting plasma glucose level of 72 mg/dL and a glycosylated hemoglobin of 5.3%. She was treated with gatifloxacin for an infected ovarian cyst found on laparotomy. Her subsequent glucose values ranged from 400 to 500 mg/dL and remained high during gatifloxacin therapy. Antibiotic treatment was changed to ciprofloxacin. On outpatient follow-up, the patient's fasting plasma glucose levels had decreased to a range of 87 to 108 mg/dL. Our second patient, a 77-year-old woman with a history of chronic renal failure and congestive heart failure, was hospitalized because of dyspnea and hypotension. S...Continue Reading

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