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Aminoglycoside-associated hypomagnesaemia in children with cystic fibrosis

A Akbar1, J H Rees, G Nyamugunduru

  • 1Paediatric Respiratory and Cystic Fibrosis Unit, The Birmingham Children's Hospital NHS Trust, UK.

Acta Paediatrica (Oslo, Norway : 1992)
|August 14, 1999
PubMed

Insights

Hypomagnesaemia, low magnesium levels, is a risk for children with cystic fibrosis (CF) treated with aminoglycosides. Regular serum magnesium screening is recommended for CF patients receiving multiple aminoglycoside courses.

Area of Science:

  • Pediatric Nephrology
  • Pulmonology
  • Clinical Pharmacy

Background:

  • Cystic Fibrosis (CF) management often involves intravenous aminoglycosides for bacterial infections.
  • Aminoglycoside nephrotoxicity is a known complication, but its role in magnesium wasting is under-recognized.
  • Hypomagnesaemia can exacerbate other CF-related complications.

Observation:

  • A case of significant hypomagnesaemia in a pediatric cystic fibrosis patient post-intravenous aminoglycoside therapy for Pseudomonas aeruginosa infection.
  • Three additional similar cases were identified.
  • Renal magnesium wasting was confirmed in two of the affected patients.

Findings:

  • Repeated courses of intravenous aminoglycosides may cause cumulative renal tubular damage.
  • This damage can lead to excessive renal loss of magnesium, resulting in hypomagnesaemia.
  • Hypomagnesaemia appears to be an under-recognized complication in pediatric CF patients undergoing extensive aminoglycoside treatment.

Implications:

  • Routine serum magnesium monitoring should be implemented for cystic fibrosis patients receiving multiple aminoglycoside courses.
  • Early detection and management of hypomagnesaemia can prevent further complications.
  • This highlights the importance of considering electrolyte disturbances in CF patients with prolonged antibiotic therapy.

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