Table 2.
Emergency room Visits for Hypoglycemia Within 14 Days of Antibiotic Exposure Among Glipizide/Glyburide Users (5% Medicare data, 2008–2010)
| Coadministration | Glipizide | Glyburide | ||||||
|---|---|---|---|---|---|---|---|---|
| Co-trimoxazole | Amoxicillin | Cephalexin | Azithromycin | Co-trimoxazole | Amoxicillin | Cephalexin | Azithromycin | |
| Characteristics | ||||||||
| N of episodes | 4,323 | 6,211 | 4,586 | 6,353 | 3,079 | 4,867 | 3,393 | 4,815 |
| % by the same prescriber | 59.1 | 46.5 | 49.2 | 63.0 | 56.5 | 44.2 | 47.0 | 63.1 |
| % filled at the same pharmacy | 86.3 | 82.5 | 85.0 | 82.5 | 86.8 | 81.0 | 83.8 | 82.6 |
| % by days of overlap* | ||||||||
| 1–4 days | 12.7 | — | — | — | 12.1 | — | — | — |
| 5–9 days | 42.9 | — | — | — | 43.0 | — | — | — |
| 10+ days | 44.4 | — | — | — | 44.9 | — | — | — |
| Hypoglycemia emergency room visits | ||||||||
| N (%) | 53 (1.23) | 19 (0.31) | 20 (0.44) | 16 (0.25) | 27 (0.88) | 10 (0.21) | 13 (0.38) | 12 (0.25) |
| OR† (95% CI) | ||||||||
| Reference: Amoxicillin | 3.89 (2.29–6.60) | — | — | — | 3.78 (1.81–7.90) | — | — | — |
| Reference: Cephalexin | 2.70 (1.61–4.54) | — | — | — | 2.17 (1.11–4.23) | — | — | — |
| Reference: Azithromycin | 4.79 (2.73–8.41) | — | — | — | 3.10 (1.55–6.17) | — | — | — |
*The days of overlap was based on the fill dates and days of supply of the antibiotic and sulfonylurea prescriptions. For example, there was 10 days’ overlap for a patient who filled a glyburide prescription on May 1, 2008 with 30 days of supply and also a co-trimoxazole prescription on May 20, 2008 with 10 days of supply. The information was not provided for reference antibiotics because it was not of study interest.
†Adjusted for age, sex, race/ethnicity, Medicaid eligibility, comorbidity, and number of hospitalizations in the previous year.