Research Journal of Pharmacology and Pharmacodynamics

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Gatifloxacin Induced Dysglycemic Behaviour and Its Impact on Worldwide Patients


Affiliations
1 Department of Pharmacology, Himalayan Institute of Pharmacy & Research, Rajawala, Dehradun, Uttarakhand (India), India
     

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Gatifloxacin, a synthetic, novel fluoroquinolone, broad-spectrum antimicrobial agent, is primarily indicated for the treatment of upper respiratory tract infections, urinary tract infections and many more infectious disorders. It acts by inhibiting DNA gyrase and also by inhibiting topoisomerase IV for bacterial infections. Its absolute bioavailability is approximately 96%, extensively distributed into many tissues and body fluids, elimination half-life is approximately 8 hours and major route of elimination is urinary excretion of unchanged drug, with renal clearance accounting for >70%. Approximately 82-88% was recovered in urine as unchanged drug and 6% was recovered in feces. Gatifloxacin was reported to be associated with many serious glycemic abnormalities mostly observed in diabetic as well as in non-diabetic patients. Hypoglycemia usually occurs immediately after the administration while hyperglycemia often takes several days to develop and discontinuation of gatifloxacin treatment markedly improves glucose homeostasis in many cases. It was observed that dysglycemia occurs more frequently in elderly patients, patients with renal insufficiency, diabetic patients, and patients taking medications for diabetics (mainly hypoglycemic agents). One of the study identified that increased gatifloxacin exposure correlates with age-related decreases in renal function and may be responsible for elderly patients being at an increased risk for hyperglycemia. Failure to adjust the dose of gatifloxacin for renal insufficiency has been commonly associated with gatifloxacin-induced hypoglycemia and hyperglycemia. Some researchers observed high incidence rates of hyperglycemia in patients with diabetes compared to those without diabetes while some found no significant difference. Patients receiving glucose lowering medications were at the greatest risk for gatifloxacinassociated hyperglycemic events and patient's not receiving glucoselowering medications also had a significantly increased risk of hyperglycemia. Gatifloxacin is still being used in various parts of the world for treatment of infectious diseases. Therefore, gatifloxacin should be used with caution while undergoing treatment with gatifloxacin.

Keywords

Gatifloxacin, Hyperglycemia, Hypoglycemia, Elderly Patients
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  • Gatifloxacin Induced Dysglycemic Behaviour and Its Impact on Worldwide Patients

Abstract Views: 255  |  PDF Views: 2

Authors

Yogesh Joshi
Department of Pharmacology, Himalayan Institute of Pharmacy & Research, Rajawala, Dehradun, Uttarakhand (India), India

Abstract


Gatifloxacin, a synthetic, novel fluoroquinolone, broad-spectrum antimicrobial agent, is primarily indicated for the treatment of upper respiratory tract infections, urinary tract infections and many more infectious disorders. It acts by inhibiting DNA gyrase and also by inhibiting topoisomerase IV for bacterial infections. Its absolute bioavailability is approximately 96%, extensively distributed into many tissues and body fluids, elimination half-life is approximately 8 hours and major route of elimination is urinary excretion of unchanged drug, with renal clearance accounting for >70%. Approximately 82-88% was recovered in urine as unchanged drug and 6% was recovered in feces. Gatifloxacin was reported to be associated with many serious glycemic abnormalities mostly observed in diabetic as well as in non-diabetic patients. Hypoglycemia usually occurs immediately after the administration while hyperglycemia often takes several days to develop and discontinuation of gatifloxacin treatment markedly improves glucose homeostasis in many cases. It was observed that dysglycemia occurs more frequently in elderly patients, patients with renal insufficiency, diabetic patients, and patients taking medications for diabetics (mainly hypoglycemic agents). One of the study identified that increased gatifloxacin exposure correlates with age-related decreases in renal function and may be responsible for elderly patients being at an increased risk for hyperglycemia. Failure to adjust the dose of gatifloxacin for renal insufficiency has been commonly associated with gatifloxacin-induced hypoglycemia and hyperglycemia. Some researchers observed high incidence rates of hyperglycemia in patients with diabetes compared to those without diabetes while some found no significant difference. Patients receiving glucose lowering medications were at the greatest risk for gatifloxacinassociated hyperglycemic events and patient's not receiving glucoselowering medications also had a significantly increased risk of hyperglycemia. Gatifloxacin is still being used in various parts of the world for treatment of infectious diseases. Therefore, gatifloxacin should be used with caution while undergoing treatment with gatifloxacin.

Keywords


Gatifloxacin, Hyperglycemia, Hypoglycemia, Elderly Patients

References