加替沙星致高血糖2例

Hyperglycemia induced by gatifloxacin:2 case reports

2例患者静脉滴注加替沙星引发高血糖。第1例为81岁男性,因慢性阻塞性肺疾病急性加重,给予加替沙星0.4g+5%葡萄糖注射液250ml静脉滴注,1次/d。3d后患者出现烦躁、多尿、口渴、疲劳,血糖由用药前6.01mmol/L升至28.84mmol/L。立即停用加替沙星,给予12U胰岛素静脉滴注,2d后血糖恢复到5.2mmol/L。第2例为61岁男性梗阻性胆管炎、胆汁淤积性肝硬化患者,给予加替沙星0.4g+5%葡萄糖注射液250ml静脉滴注,1次/d,谷胱甘肽1.2g+葡萄糖氯化钠注射液250ml静脉滴注,1次/d,消炎利胆片6片,3次/d。治疗后第4天,血糖由用药前的5.60mmol/L升为13.81mmol/L。遂停用加替沙星,改为克林霉素静脉滴注。3d后血糖降至5.84mmol/L。

Two elderly patients developed hyperglycemia after intravenous infusion of gatifloxacin. The first patient, an 81-year-old man with acute exacerbation of chronic obstructive pulmonary diseases received intraveous infusion of gatifloxacin 0. 4 g mixed with 250 ml of glucose injection 5% once daily. Three days later, he presented with dysphoria, polyuria, polydipsia, and fatigue. His blood glucose rose from 6.01 mmol/L to 28.84 mmol/L. Gatifloxacin was stopped. He was treated with Ⅳ insulin 12 U. Two days later, his blood glucose declined to 5.2 mmol/L. The second patient, a 61-year-old man with obstructive cholangitis and cholestatic cirrhosis received intravenous infusion of gatifloxacin 0.4 g mixed with 250 ml of glucose injection 5% once daily, glutathione 1.2 g mixed with 250 ml of glucose and sodium chloride injection once daily, and Xiaoyanlidan tablets 6 tablets thrice daily. On day 4 after treatment, his blood glucose increased from 5.60 mmol/L to 13.81 mmol/L. Then clindamycin was given instead of gatifloxacin. Three days later, his blood glucose dropped to 5. 84 mmol/L.