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. 2017 Dec;4(1):10.
doi: 10.1007/s40800-017-0052-1.

Reversible Hypokalemia and Bartter-Like Syndrome during Prolonged Systemic Therapy with Colistimethate Sodium in an Adult Patient

Tarek Kamal Eldin  1 , Grazia Tosone  2 , Alfredo Capuano  3 , Raffaele Orlando  2
Affiliations

Reversible Hypokalemia and Bartter-Like Syndrome during Prolonged Systemic Therapy with Colistimethate Sodium in an Adult Patient

Tarek Kamal Eldin et al. Drug Saf Case Rep. 2017 Dec.

Abstract

We present the case of a 58-year-old woman who developed hypokalaemia and metabolic alkalosis 2 weeks after therapy with colistimethate sodium for the treatment of chronic lower limb ulcer infection by extensively drug-resistant (XDR) Pseudomonas aeruginosa. The metabolic changes observed resembled Bartter syndrome, a group of congenital disorders affecting the distal segments of the renal tubules. The metabolic abnormalities reversed spontaneously 6 days after drug discontinuation. Acquired forms of Bartter syndrome have been reported during courses of antibiotic therapy; however, to our knowledge, this is the first documented case associated with colistimethate therapy in an adult.

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Conflict of interest statement

Funding

No funds were received in support of this work.

Conflict of interest

Tarek Kamal Eldin, Grazia Tosone, Alfredo Capuano and Raffaele Orlando have no conflicts of interest.

Ethics

The patient provided written informed consent for publication of this case report. A copy of the written consent may be requested for review from the corresponding author.

Figures

Fig. 1
Fig. 1
Levels of serum potassium and creatinine followed and analysed throughout hospitalization of a case of ulcer infection receiving systemic colistimethate sodium. Lower normal limit (LNL) of serum potassium (K) and upper normal limit (UNL) of serum creatinine (Creat.) are shown. Timing and duration of treatment with colistimethate sodium, gentamicin (Gent.) and potassium chloride supplementation (KCl) is indicated
See this image and copyright information in PMC

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