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Ciprofloxacin and risk of hypolycemia in non-diabetic patients

BACKGROUND: Fluoroquinolones have been associated with hypoglycemia in patients taking diabetic medications, most commonly due to drug-drug interactions and other associated risk factors. Except for four published case reports, there are no studies that have found positive associations between cipro...

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Autores principales: Berhe, Abiel, Russom, Mulugeta, Bahran, Fithawit, Hagos, Goitom
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6511658/
https://www.ncbi.nlm.nih.gov/pubmed/31078137
http://dx.doi.org/10.1186/s13256-019-2083-y
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author Berhe, Abiel
Russom, Mulugeta
Bahran, Fithawit
Hagos, Goitom
author_facet Berhe, Abiel
Russom, Mulugeta
Bahran, Fithawit
Hagos, Goitom
author_sort Berhe, Abiel
collection PubMed
description BACKGROUND: Fluoroquinolones have been associated with hypoglycemia in patients taking diabetic medications, most commonly due to drug-drug interactions and other associated risk factors. Except for four published case reports, there are no studies that have found positive associations between ciprofloxacin and hypoglycemia. In all but one of the cases, ciprofloxacin was taken with other hypoglycemic drugs. Recently, the Eritrean National Pharmacovigilance Centre received a serious case of hypoglycemia with recurrent episodes in a young and healthy patient without diabetes following use of oral ciprofloxacin. The aim of the present study is therefore to assess the causal relationship between ciprofloxacin and hypoglycemia in patients without diabetes using the World Health Organization-Uppsala Monitoring Centre global adverse drug reaction database (VigiBase®). METHODS: A search was made on the World Health Organization global adverse drug reaction database (August 15, 2018) using “ciprofloxacin” as the drug substance and “hypoglycemia” as the reaction term. Cases that used hypoglycemic drugs (patients with diabetes) concurrently with ciprofloxacin and those with a completeness score below 50% were excluded to control for confounders and to improve the strength of the data. Hill criteria were used to assess causation. RESULTS: A total of 35 cases of hypoglycemia reported since 1989 from 17 countries in patients without diabetes associated with ciprofloxacin use with a median time to onset of 4 days were retrieved. The cases have a median age of 64 years (interquartile range, 50–85) with a similar male–to-female ratio. Ciprofloxacin was the only suspect and the sole drug administered in 48.5% of the cases. In ten cases, hypoglycemia abated following withdrawal of ciprofloxacin, and reaction recurred in one case on the subsequent rechallenge. Hypoglycemia was marked as “serious” in 20 cases, and the outcome was fatal in two cases. CONCLUSIONS: This assessment found a suggestive causal link between use of ciprofloxacin and hypoglycemia in patients without diabetes.
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spelling pubmed-65116582019-05-20 Ciprofloxacin and risk of hypolycemia in non-diabetic patients Berhe, Abiel Russom, Mulugeta Bahran, Fithawit Hagos, Goitom J Med Case Rep Research Article BACKGROUND: Fluoroquinolones have been associated with hypoglycemia in patients taking diabetic medications, most commonly due to drug-drug interactions and other associated risk factors. Except for four published case reports, there are no studies that have found positive associations between ciprofloxacin and hypoglycemia. In all but one of the cases, ciprofloxacin was taken with other hypoglycemic drugs. Recently, the Eritrean National Pharmacovigilance Centre received a serious case of hypoglycemia with recurrent episodes in a young and healthy patient without diabetes following use of oral ciprofloxacin. The aim of the present study is therefore to assess the causal relationship between ciprofloxacin and hypoglycemia in patients without diabetes using the World Health Organization-Uppsala Monitoring Centre global adverse drug reaction database (VigiBase®). METHODS: A search was made on the World Health Organization global adverse drug reaction database (August 15, 2018) using “ciprofloxacin” as the drug substance and “hypoglycemia” as the reaction term. Cases that used hypoglycemic drugs (patients with diabetes) concurrently with ciprofloxacin and those with a completeness score below 50% were excluded to control for confounders and to improve the strength of the data. Hill criteria were used to assess causation. RESULTS: A total of 35 cases of hypoglycemia reported since 1989 from 17 countries in patients without diabetes associated with ciprofloxacin use with a median time to onset of 4 days were retrieved. The cases have a median age of 64 years (interquartile range, 50–85) with a similar male–to-female ratio. Ciprofloxacin was the only suspect and the sole drug administered in 48.5% of the cases. In ten cases, hypoglycemia abated following withdrawal of ciprofloxacin, and reaction recurred in one case on the subsequent rechallenge. Hypoglycemia was marked as “serious” in 20 cases, and the outcome was fatal in two cases. CONCLUSIONS: This assessment found a suggestive causal link between use of ciprofloxacin and hypoglycemia in patients without diabetes. BioMed Central 2019-05-12 /pmc/articles/PMC6511658/ /pubmed/31078137 http://dx.doi.org/10.1186/s13256-019-2083-y Text en © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Berhe, Abiel
Russom, Mulugeta
Bahran, Fithawit
Hagos, Goitom
Ciprofloxacin and risk of hypolycemia in non-diabetic patients
title Ciprofloxacin and risk of hypolycemia in non-diabetic patients
title_full Ciprofloxacin and risk of hypolycemia in non-diabetic patients
title_fullStr Ciprofloxacin and risk of hypolycemia in non-diabetic patients
title_full_unstemmed Ciprofloxacin and risk of hypolycemia in non-diabetic patients
title_short Ciprofloxacin and risk of hypolycemia in non-diabetic patients
title_sort ciprofloxacin and risk of hypolycemia in non-diabetic patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6511658/
https://www.ncbi.nlm.nih.gov/pubmed/31078137
http://dx.doi.org/10.1186/s13256-019-2083-y
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