Aminoglycosides Lower Serum Magnesium Concentrations in Patients with Cystic Fibrosis: A Retrospective Study

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Methods

Male (n=122) and female (n=106) patients diagnosed with CF were included in this study, regardless of age or history of aminoglycoside therapy. The study was approved by the Institutional Review Board of Children's Hospital Medical Center, Cincinnati, Ohio. A retrospective review of the lifetime medical records of the 228 CF patients was completed. The most recent serum magnesium concentration (determined when the patient was not receiving antibiotics intravenously) was recorded, compared with

Results

Age, lifetime aminoglycosides received (tobramycin and gentamicin), and serum magnesium data are summarized in the (Table). Sample size differs for the variables as a result of missing data from incomplete and/or missing portions of medical records. Of the patients with recorded magnesium levels (n=192), 97% had values within normal limits. The one case of symptomatic hypomagnesemia did not appear secondary to malnutrition as measured by serum albumin level. Hypocalcemia or hypokalemia was not

Discussion

The results of this study indicate that lifetime doses of tobramycin and total aminoglycosides were negatively correlated to serum magnesium concentrations, and that persons who had never received aminoglycosides intravenously had significantly higher serum magnesium concentrations than those who had received aminoglycosides. The lifetime aminoglycoside dose, however, was not associated with chronic hypomagne-semia. Only 3% (6 of 192) of the population studied had magnesium levels that were not

Applications

Persons with CF who have received chronic aminoglycoside therapy have serum magnesium concentrations in the low-normal range. Further study is needed to determine whether these magnesium values drop below normal during aminoglycoside treatment. More frequent doses of aminoglycosides, resulting in larger lifetime quantities, are being used as part of a more aggressive therapy to prevent progression of lung disease. This aggressive therapy does not appear to have a chronic effect on magnesium

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