Several antibiotics were found to be associated with hypoglycemia even after accounting for concomitant use of glucose-lowering medications, according to the findings of a recent epidemiologic surveillance study.

To investigate the association between antibiotics and hypoglycemia, both alone and in combination with sulfonylureas and meglitinides, study authors utilized the US Food and Drug Administration Adverse Event Reporting System (FAERS) to access relevant reports published between January 1, 2004 and December 31, 2017. “Reporting odds ratios (RORs) and corresponding 95% confidence intervals (CIs) for the association between antibiotics and hypoglycemia were calculated,” the study authors stated. “An association was considered to be statistically significant when the lower limit of the 95% CI was > 1.0.”

They identified 2,334,959 FAERS reports, of which 18,466 reported on hypoglycemia. Findings of the study revealed a number of antibiotics to be statistically significantly associated with hypoglycemia. The RORs (95% CI) for these antibiotics were reported to be: cefditoren 14.03 (8.93-22.03), tigecycline 3.32 (1.95-5.65), clarithromycin 2.41 (1.89-3.08), ertapenem 2.07 (1.14-3.75), moxifloxacin 2.06 (1.59-2.65), levofloxacin 1.66 (1.37-2.01), and linezolid 1.54 (1.07-2.20). 

Additionally, data analysis revealed that several of these antibiotics were also associated with hypoglycemia after adjustments for concomitant sulfonylurea and meglitinide use were made. The RORs (95% CI) for these antibiotics were reported to be: cefditoren 14.25 (9.08-22.39), tigecycline 3.34 (1.96-5.68), ertapenem 1.93 (1.03-3.60), and clarithromycin 1.56 (1.15-2.11).

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“Cefditoren, tigecycline, ertapenem, and clarithromycin are associated with hypoglycemia even if not taken with sulfonylureas or meglitinides,” the authors concluded, adding that “The association between ertapenem and hypoglycemia has not been previously reported.” 

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