lowered calcium level

[Mandychelle79, ASN, RN]

Was working on my pathopapers tonight for clinical tomorrow. Both of my patients have cellulitis. one thing that they had in common was after starting iv abx to treat, their calcium levels dropped slightly. It was enough to take their levels from low-normal to slightly hypocalcemic. One of the things we have to do is tie in our abnormal results to our patients. Nothing that I found in my lab book made sense for reasons why. Both of them have high GFR's so it is not because of Kidneys, both are well noursished so its most likely not from a albumin deficient. I just think its HIGHLY unlikely that both patients would have a drop in their calcium level since they have the same dx. I did find an abstract that said that low calcium levels could be an indicator of a staph or strep infection and one of the patients, staph was the infection that caused the cellulitis, while the other one, no culture was available. Both are on mycin based drugs, but looked them up and they should not affect calcium levels.

I did use about the staph and strep in the paper, so im really not asking for homework purposes. Strictly my own knowledge. Any other reasons you can think of that their calcium levels could have dropped?

[Mike R, ADN, BSN, RN]

Dang it. You've got me so curious I've spent the last half hour looking up scholarly articles on why. So far, all I have is increased aminoglycosides doses of 4 days or longer seems to impair renal tubular transport resulting in excessive CA excretion. I'll keep looking...

Otherwise, most articles say it's a phenomenon that is not fully understood.

*another study suggests it hinders Parathyroid hormone, resulting in hypocalcemia. And I'm done.