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Antimicrobials with Special Precautions in Diabetes

Antimicrobials with Special Precautions in Diabetes is a topic covered in the Johns Hopkins Diabetes Guide.

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  • Certain antibiotics may produce undesired changes in glycemic control when used in persons with diabetes.
  • No apparent interactions are described between antibiotics and insulins.
  • Serum concentrations of hypoglycemic agents may change due to inhibition or induction of oxidative metabolism (i.e. cytochrome P450 system) including: meglitinides (repaglinide, nateglinide), sulfonylureas (glyburide, glimepiride, glipizide), and glitizones (pioglitazone, rosiglitazone).
  • Specific cytochrome P450 substrates: repaglinide (2C8, 3A4); nateglinide (2C9>3A4); glyburide and glipizide (2C9); pioglitazone (3A4>2C8); rosiglitazone (2C8> 2C9).
  • Limited number of potential drug-drug interactions observed with metformin.

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Last updated: January 5, 2017


Auwaerter, Paul. "Antimicrobials With Special Precautions in Diabetes." Johns Hopkins Diabetes Guide, 2017. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547010/all/Antimicrobials_with_Special_Precautions_in_Diabetes.
Auwaerter P. Antimicrobials with Special Precautions in Diabetes. Johns Hopkins Diabetes Guide. 2017. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547010/all/Antimicrobials_with_Special_Precautions_in_Diabetes. Accessed July 22, 2019.
Auwaerter, P. (2017). Antimicrobials with Special Precautions in Diabetes. In Johns Hopkins Diabetes Guide. Available from https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547010/all/Antimicrobials_with_Special_Precautions_in_Diabetes
Auwaerter P. Antimicrobials With Special Precautions in Diabetes [Internet]. In: Johns Hopkins Diabetes Guide. ; 2017. [cited 2019 July 22]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547010/all/Antimicrobials_with_Special_Precautions_in_Diabetes.
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TY - ELEC T1 - Antimicrobials with Special Precautions in Diabetes ID - 547010 A1 - Auwaerter,Paul,M.D. Y1 - 2017/01/05/ BT - Johns Hopkins Diabetes Guide UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547010/all/Antimicrobials_with_Special_Precautions_in_Diabetes DB - Johns Hopkins Guide DP - Unbound Medicine ER -