Abstract
Aim
Fluoroquinolone antibiotics have been implicated in cases of metabolic adverse events.
This study investigated the causal association between fluoroquinolones and serious
hypoglycemia in those with and without diabetes.
Methods
We conducted a propensity score-matched cohort study using Optum claims data. We included
adults dispensed an oral fluoroquinolone or comparator antibiotic between January
2000 and September 2015 for specific infections of interest. The outcome was serious
hypoglycemia, defined using a validated algorithm. Conditional logistic regression
was used to estimate odds ratios (ORs) in diabetes and non-diabetes cohorts after
matching on propensity scores fitted using confounding variables of interest.
Results
Our cohort contained 119,112 individuals with diabetes and 917,867 individuals without
diabetes exposed to a fluoroquinolone, matched 1:1 with a comparator. Matching produced
balance (standardized mean difference < 0.1) on all variables included in the propensity
score. The OR for the association between fluoroquinolones and serious hypoglycemia
was 1.28 (95% confidence interval [CI]: 1.04–1.57) in the entire cohort, 1.30 (95%
CI: 1.05–1.62) in individuals with diabetes, and 1.06 (95% CI: 0.53–2.13) in individuals
without diabetes.
Conclusion
Fluoroquinolone users are at an increased risk of serious hypoglycemia relative to
comparator antibiotic users. This association was evident only among persons diagnosed
with diabetes.
Keywords
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Article info
Publication history
Published online: February 02, 2022
Accepted:
January 28,
2022
Received in revised form:
December 30,
2021
Received:
August 25,
2021
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
