Effect of Ciprofloxacin versus Levofloxacin on QTc-interval and
Dysglycemia in Diabetic and Non-Diabetic Patients.
Background: Levofloxacin and ciprofloxacin are more commonly used among
fluoroquinolone class and the question of cardiac safety and glucose
hemostasis of this class has been raised. Objective: To compare
intravenous levofloxacin and ciprofloxacin regarding their risk on QTc
prolongation and dysglycemia in diabetic and non-diabetic patients.
Methods: A randomized 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 antibiotic, 24 hours, 72 hours after the
first dose and 72 hours after antibiotics cessation. Results: 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 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. Conclusion: 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.