Netilmicin-induced carpopedal spasm

Area of Science:

• Nephrology
• Pharmacology
• Internal Medicine

Background:

• Aminoglycosides are common antibiotics but can cause kidney damage (nephrotoxicity).
• Netilmicin, a gentamicin-related antibiotic, is often used for resistant infections and has a lower risk of ototoxicity and nephrotoxicity.
• Despite its safety profile, netilmicin can still lead to electrolyte disturbances.

Observation:

• Two patients developed carpopedal spasm, a symptom of low calcium levels (hypocalcemia).
• This occurred after receiving netilmicin treatment.
• The hypocalcemia was attributed to the kidneys improperly retaining electrolytes (renal electrolyte wasting).

Findings:

• Netilmicin use can lead to symptomatic hypocalcemia, hypomagnesemia, and hypokalemia.
• Renal electrolyte wasting is a potential adverse effect of netilmicin.
• Carpopedal spasm is a clinical manifestation of netilmicin-induced hypocalcemia.

Implications:

• Patients treated with netilmicin should be monitored for electrolyte imbalances, particularly calcium, magnesium, and potassium.
• Early detection and management of electrolyte wasting can prevent serious complications like carpopedal spasm.
• This case series underscores the importance of vigilance for adverse effects even with antibiotics considered safer.