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4CPS-167 Use of standard- and high-dose liposomal amphotericin b and its relationship with hypomagnesaemia
  1. R Villaro-Otaño,
  2. A Fernández-Ferreiro,
  3. M González-Barcia,
  4. F Cajade-Pascual,
  5. M Puente-Iglesias,
  6. Á Tena-Castro,
  7. I Zarra-Ferro
  1. Complejo Hospitalario Universitario De Santiago De Compostela, Hospital Pharmacist Service, Santiago De Compostela, Spain


Background and Importance Magnesium deficiency is mainly manifested in cardiac and neuromuscular disorders. Hypomagnesaemia has been described as a frequent adverse reaction associated with the intravenous administration of liposomal amphotericin B.

Aim and Objectives To compare associated hypomagnesaemia in patients with fungal infection receiving standard- versus high-dose of liposomal amphotericin B.

Material and Methods One-year retrospective observational study including patients who received liposomal amphotericin B for at least 5 days. The variables collected were age, sex, mean dose, duration of treatment, serum magnesium and need for magnesium supplementation. Patients were divided into two groups: standard doses (≤ 3 mg/kg/day) and high doses (> 3 mg/kg/day). The change in magnesium at the beginning and the end of the period studied in each of the groups was analysed.

Results A total of 31 patients (38% women) with a mean age of 60±13 years were included. The baseline magnesium value of the patients who started treatment was 1.95±0.34 mg/dl, with only two patients being below the physiological range (1.6–2.4 mg/dl).

In the standard dose group, 11 patients (35%) were included with a mean dose of 1.63±0.84 mg/kg/day and a mean duration of 22±10 days. At five days, no patient was below the physiological range, although magnesium decreased by an average of 0.076 mg/dl (4% with respect to baseline). This meant that 45% of the patients had to be supplemented with intravenous magnesium. In the high-dose group, 20 patients (64%) were included, who received a mean dose of 4.88±0.91 mg/kg/day for a mean of 17±10 days. On the fifth day, 20% of the patients showed levels below the physiological range of magnesium. Furthermore, the mean decrease in this group was 0.195 mg/dl (10%), with 65% requiring exogenous supplementation. There are statistically significant differences (p<0.05) showing that a greater decrease in serum magnesium levels is associated with high-dose amphotericin.

Conclusion and Relevance Real-life data show a greater decrease in serum magnesium with high doses of liposomal amphotericin B. Therefore, monitoring and follow-up of these patients -who will require more frequent magnesium supplementation- is a priority.

Conflict of Interest No conflict of interest.

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