Gatifloxacin-induced hypoglycemia: A case report and review of the literature

Objective: To describe a case of hypoglycemia related to gatifloxacin use in a patient with non-insulin dependent diabetes mellitus. Clinical Features: An 84 year old male who was treated with glyburide for non-insulin dependent diabetes mellitus experienced severe hypoglycemia following gatifloxacin therapy. The patient's blood sugar dropped from 247mg/dL upon admission to 35 mg/dL the morning after gatifloxacin administration. The hypoglycemia was not reversed despite several n-travenous dextrose administrations. After discontinuation of the gatifloxacin, hypoglycemia was reversed and the blood sugar was increased to 543 mg/dL. Proper control of blood sugar was later maintained with a sliding scale insulin during the hospital admission, and then the patient was switched back to glyburide before hospital discharge. Conclusion: Gatifloxacin has the potential to produce clinically significant hypogy-cemia that may not be anticipated by some clinicians. The mechanism for this adverse drug event may be linked to an increase in insulin secretion induced by gatifloxacin. This reaction appears to be more common in diabetic patients.