Obat golongan fluoroquinolone diperkirakan dapat meningkatkan risiko disglikemia dan neuropati pada pasien diabetes mellitus, sehingga peresepan pada populasi diabetik perlu dilakukan secara berhati-hati. Beberapa contoh obat golongan fluoroquinolone adalah ciprofloxacin, levofloxacin, moxifloxacin, dan ofloxacin.[1.2]
Penggunaan fluoroquinolone sebagai antimikroba pada pasien diabetes mellitus sering bermaksud untuk mengatasi infeksi akibat kondisi hiperglikemik. Contoh infeksi yang sering terjadi pada pasien diabetes adalah tuberkulosis, infeksi saluran kemih (ISK), infeksi saluran napas, infeksi saluran cerna, infeksi jaringan lunak dan kulit, infeksi rongga mulut, dan infeksi telinga.[2,3,5]
Fluoroquinolone merupakan antibiotik spektrum luas yang terbukti efektif mengatasi infeksi, termasuk pada pasien diabetes mellitus. Namun, ada kekhawatiran mengenai efek fluoroquinolone pada populasi diabetik, yaitu disglikemia dan neuropati.[2,3,5]
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Referensi
1. Matoi A, Taguchi M, Nishi S. Fatal hypoglycemia with ciprofloxacin in a dialysis patient: A case report. Clin Case Rep. 2021;9:1902–1904 DOI:10.1002/ccr3.3871
2. Tang Yu-Hsin, Lu Po-Liang, et al. Clinical effectiveness of beta-lactams versus fluoroquinolones as empirical therapy in patients with diabetes mellitus hospitalized for urinary tract infections: A retrospective cohort study. PLoS ONE. 2021;17(3):e0266416 DOI: https://doi.org/10.1371/journal.pone.0266416
3. Majda A, Rostoff P, et al. Levofloxacin-induced life-threatening hypoglycemia in a type 2 diabetic patient with ST-segment elevation myocardial infarction and community-acquired pneumonia. Clinical Diabetology. 2020;9(2):141-143 DOI:10.5603/DK.2020.0011
4. Sutanti R, Manggau M A, Abdullah A A. Studi Efek Disglikemia pada Penggunaan Injeksi Ciprofloxacin dan Levofloxacin dengan Kombinasi Antidiabetik Oral dan Insulin pada Pasien Diabetes Melitus di Instalasi Rawat Inap RSUD Lasinrang, Pinrang, Sulawesi Selatan. MFF. 2020;24(3):83-86
5. Yarrington M E, Anderson D J, Ashley E D, et al. Impact of FDA black box warning on fluoroquinolone and alternative antibiotic use in southeastern US hospitals. Infection Control & Hospital Epidemiology. 2019;0:1–4 DOI:10.1017/ice.2019.247
6. Althaqafi A, Ali M, Alzahrani Y, et al. How Safe are Fluoroquinolones for Diabetic Patients? A Systematic Review of Dysglycemic and Neuropathic Effects of Fluoroquinolones. Therapeutics and Clinical Risk Management. 2021;17:1083–1090
7. Ashmawy R, Ahmed J M, Chennawi Ingie A E El, et al. Dysglycemic Effect and Misuse Prevalence of Fluoroquinolones in ICU Diabetic Patients. Acta Scientific Pharmaceutical Sciences. 2020;4(12):36-46
8. Morales D, Pacurariu A, et al. Association Between Peripheral Neuropathy and Exposure to Oral Fluoroquinolone or Amoxicillin-Clavulanate Therapy. JAMA Neurol. 2019;76(7):827-833 DOI:10.1001/jamaneurol.2019.0887
9. Gupta T, Mulkalwar S, et al. A comparative study of effect of fluoroquinolones on blood glucose levels in rats. Int J Basic Clin Pharmacol. 2020;9(8):1217-1221 DOI:http://dx.doi.org/10.18203/2319-2003.ijbcp20203137
10. Kennedy K E, Teng C, et al. Hypoglycemia Associated with Antibiotics Alone and in Combination with Sulfonylureas and Meglitinides: An Epidemiologic Surveillance Study of the FDA Adverse Event Reporting System (FAERS). Drug Saf. 2020;43(4):363–369 DOI:10.1007/s40264-019-00901-7
11. Baggio D, Ananda-Rajah M R. Fluoroquinolone antibiotics and adverse events. Aust Prescr. 2021;44:161–4 DOI: https://doi.org/10.18773/austprescr.2021.035
12. Rusu A , Munteanu A C, et al. Overview of Side-Effects of Antibacterial Fluoroquinolones: New Drugs versus Old Drugs, a Step Forward in the Safety Profile?. Pharmaceutics. 2023;15(804): 1-62 DOI: https://doi.org/10.3390/pharmaceutics15030804
13. North Central London Joint Formulary Committee. Safe prescribing of fluoroquinolones Position Statement. NHS. 2021;2:1-4. https://www.ncl-mon.nhs.uk/wp-content/uploads/5_Fluoroquinolones_Safe_Prescribing_Position_Statement.pdf
14. OptumRx. Fluoroquinolone Antibiotics – Warning updates. OptumRx. 2018;0:1-2. https://professionals.optumrx.com/content/dam/optum3/professional-optumrx/news/rxnews/drug-approvals/drugsafety_fluoroquinolone_2018-0712.pdf
15. Liao Shu-Hui, Hu Sung-Yuan, et al. Risk for hypoglycemic emergency with levofloxacin use, a population-based propensity score matched nested case-control study. PLoS ONE. 2022;17(4):e0266471 DOI: https://doi.org/10.1371/journal.pone.0266471