Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt.
Pharmacology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
Int J Clin Pract. 2021 May;75(5):e14072. doi: 10.1111/ijcp.14072. Epub 2021 Feb 12.
Levofloxacin and ciprofloxacin are more commonly used amongst fluoroquinolone class and the question of cardiac safety and glucose hemostasis of this class has been raised.
To compare intravenous levofloxacin and ciprofloxacin regarding their risk on QTc prolongation and dysglycemia in diabetic and non-diabetic patients.
A randomised prospective study at Beni-Suef university hospital was conducted on 200 adult patients over 6 months. The patients received intravenous levofloxacin 750mg once daily or ciprofloxacin 400mg twice daily. Electrocardiogram and fasting blood glucose were obtained from each patient before starting the antibiotic, 24 hours, 72 hours after the first dose, and 72 hours after antibiotics cessation.
The results of the current study showed the relative risk for QTc prolongation with levofloxacin was more than ciprofloxacin by about 4 and 1.5 times in diabetic and non-diabetic patients, respectively. The relative risk for dysglycemia with levofloxacin was 2.28 and 1.39 times more than ciprofloxacin in diabetic and non-diabetic patients, respectively.
The present study showed that the risk for QTc prolongation and hyperglycemia was greater with levofloxacin than ciprofloxacin in diabetic and non-diabetic patients. In addition, the risk for hypoglycemia was greater with levofloxacin than ciprofloxacin in non-diabetic patients.
左氧氟沙星和环丙沙星在氟喹诺酮类药物中更为常用，人们对该类药物的心脏安全性和血糖稳定性提出了质疑。
比较左氧氟沙星和环丙沙星在糖尿病和非糖尿病患者中致 QTc 延长和血糖异常的风险。
本研究为 6 个月期间在贝尼苏夫大学医院进行的一项随机前瞻性研究，共纳入 200 例成年患者。患者接受左氧氟沙星 750mg 每日一次或环丙沙星 400mg 每日两次静脉注射。在开始使用抗生素之前、首次给药后 24 小时、72 小时以及抗生素停药后 72 小时，从每位患者获取心电图和空腹血糖。
本研究结果显示，与环丙沙星相比，左氧氟沙星致 QTc 延长的相对风险在糖尿病和非糖尿病患者中分别高出约 4 倍和 1.5 倍。左氧氟沙星致血糖异常的相对风险在糖尿病和非糖尿病患者中分别是环丙沙星的 2.28 倍和 1.39 倍。
本研究表明，与环丙沙星相比，左氧氟沙星在糖尿病和非糖尿病患者中致 QTc 延长和高血糖的风险更大。此外，在非糖尿病患者中，左氧氟沙星致低血糖的风险大于环丙沙星。
