DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20203137

A comparative study of effect of fluoroquinolones on blood glucose levels in rats

Tanya Gupta, Sarita Mulkalwar, Vishwanath Kulkarni, Sudhir Jadhav, Abhijeet Tilak, Bhalchandra Rane

Abstract


Background: Fluoroquinolones (FQ) are frequently prescribed because of their broad-spectrum applicability in treatment of community acquired pneumonia and urinary tract infections. Increased use has raised some concerns regarding side effects like dysglycaemia, tendon rupture and QT interval prolongation. Gatifloxacin was banned in India in 2011 for causing fatal hypoglycemia. This study compares the effect of different fluoroquinolones on blood glucose levels in rats.

Methods: 24 rats were divided into four study groups. Each group was administered one fluoroquinolone namely levofloxacin 9 mg, moxifloxacin 7.2 mg, ciprofloxacin 18 mg and ofloxacin 14.4 mg respectively for five days. The changes in blood glucose levels were observed for 10 days.

Results: The mean blood glucose levels in all the four groups dropped below the baseline by day five. A statistically significant reduction in mean glucose levels was found in the moxifloxacin, ciprofloxacin and levofloxacin group. Among the rats that were given ofloxacin, the reduction in the mean blood glucose levels was not statistically significant. After stopping the drugs, the blood glucose levels in all the four groups returned near to the baseline within five days.

Conclusions: The use of fluoroquinolones causes hypoglycemia in rats. The blood glucose level reduction associated with moxifloxacin was maximum, whereas ofloxacin appeared to have the minimum effect on blood glucose levels. These effects do not appear to be permanent and the dysglycaemia subsided after the drugs were stopped.


Keywords


Fluoroquinolones, Hypoglycemia, Moxifloxacin, Levofloxacin, Blood glucose, Rats

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References


Emmerson AM, Jones AM. The quinolones: decades of development and use. J Antimicrobial Chemotherapy. 2003;51(1):13-20.

Chen HJ, Bloch KJ, Maclean JA. Acute eosinophilic hepatitis from trovafloxacin. New England J Med. 2000;342:359-60.

Ball P. Quinolone-induced QT interval prolongation: a not-so-unexpected class effect. J Antimicrobial Chemotherapy. 2000;45:557-9.

Wyllie PLY, Juurlink DN, Kopp A, Shah BR, Stukel TA, Stumpo C, et al. Outpatient gatifloxacin therapy and dysglycemia in older adults. New England J Med. 2006;354(13):1352-61.

Ahmad A, Patel I, Sanyal S, Balkrishnan R, Mohanta GP. A study on drug safety monitoring program in India. Indian J Pharmaceutical Sciences. 2014;76(5):379.

Lawrence KR, Adra M, Keir C. Hypoglycemia-induced anoxic brain injury possibly associated with levofloxacin. J Infect. 2006;52:177-80.

Singh M, Jacob JJ, Kapoor R, Abraham J. Fatal hypoglycemia with levofloxacin use in an elderly patient in the post-operative period. Langenbecks Arch Surg. 2008;393:235-8.

Friedrich LV, Dougherty R. Fatal hypoglycemia associated with levofloxacin. Pharmacotherapy. 2004;24:1807-12.

Gibert AE, Porta FS. Hypoglycemia and levofloxacin: a case report. Clin Infect Dis. 2008;46:1126-7.

Kapoor R, Blum D, Batra A, Varma N, Lakshmi K, Basak P, et al. Life‚ÄźThreatening Hypoglycemia with Moxifloxacin in a Dialysis Patient. J Clin Pharmacol. 2012;52(2):269-71.

Mandavia R, Virpariya MM, Patel TK, Tripathi CB. Moxifloxacin-induced hypoglycemia in a non-diabetic patient. Current Drug Safety. 2012;7(2):183-5.

Kobayashi N, Tsuhako Y, Matsuyama R, Fujinaga M, Nakamoto M. Hypoglycemic attacks in three patients with non-diabetic chronic renal failure on hemodialysis, with discussion of a patient who showed enoxacin-induced hypoglycemia. J Japan Soc Dial Ther. 1991;24:951-6.

Tack KJ, Smith JA. The safety profile of ofloxacin. Am J Med. 1989;87(6C):78-81.

Ishiwata Y, Takahashi Y, Nagata M, Yasuhara M. Effects of Moxifloxacin on Serum Glucose Concentrations in Rats. Biol Pharm Bull. 2013;36(4):686-90.

Ishiwata Y, Itoga Y, Yasuhara M. Effect of levofloxacin on serum glucose concentration in rats. European J Pharmacol. 2006;551:168-74.

Acharya A, Halemani SS, Adake P. Evaluation of Levofloxacin vs. Norfloxacin; Effect on Blood Glucose Profile in Alloxan Induced Diabetic Albino Rats- A Comparative Study. Int J Pharm Sci Res. 2016;7(9):3893-98.

Hori S, Kizu J, Kawamura M. Effect of fluoroquinolones on plasma glucose levels in fasted and glucose-loaded mice. J Infect Chemother. 2006;12:109-111.

Maeda N, Tamagawa T, Niki I. Increase in insulin release from rat pancreatic islets by quinolone antibiotics. Br J Pharmacol. 1996;117:372-6.

Hamaid NEA, Mostafa IM. Relationship between Ciprofloxacin and blood glucose level, glucose transporters in adult male rats. J Am Sci. 2015;11(3):132-7.

Kabbara WK, Ramadan WH, Rahbany P, Natour AS. Evaluation of the appropriate use of commonly prescribed fluoroquinolones and the risk of dysglycemia. Ther Clin Risk Manag. 2015;11:639-47.

Murad M, Yglesias CF, Wang A, Sheidaee N, Mullan R, Elamin M, et al. Drug-induced hypoglycemia: a systematic review. J Clin Endocrinol Metab. 2009;3(94):741-5.