{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T09:28:00Z","timestamp":1776763680212,"version":"3.51.2"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Bartter syndrome encompasses salt-losing tubulopathies characterized by hypokalaemia, hypochloremic metabolic alkalosis and hyperreninemic hyperaldosteronism with normal blood pressure and renal function. Acquired Bartter-like syndrome (ABLS) is commonly associated with diuretics and antibiotics such as aminoglycosides, colistin and amphotericin B. This review aims to understand the timing of Bartter syndrome onset after exposure to inciting drugs and explore its progression and management.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A systematic review was conducted following PRISMA guidelines. Databases searched include PubMed, Embase, medRxiv and bioRxiv. Case reports, case series and review articles from 1986 to March 2022 were screened. Forty-three cases were included, consisting of five case series and the rest as case reports.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The most common antimicrobial associated with ABLS was gentamicin (41.8%), followed by colistin (32.5%). The most frequent symptoms were paraesthesias (27.9%) and carpopedal spasms (27.9%), while 32.5% of patients were asymptomatic. Laboratory findings showed hypokalaemia (100%), metabolic alkalosis (97.2%), hypocalcaemia (92.5%) and hypomagnesaemia (100%), with renal wasting of these electrolytes but normal serum creatinine. The median time for Bartter-like syndrome to appear post-drug exposure was 10\u2005days (IQR 7\u201318\u2005days), with resolution occurring within 14\u2005days (IQR 7\u201331\u2005days) after drug discontinuation. Symptoms resolved completely upon cessation of the offending agent.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>ABLS, though rare, should be suspected in patients on antimicrobials presenting with salt-losing tubulopathy. Aminoglycosides are the most frequently implicated drugs. Discontinuation of the offending drug, along with fluid and electrolyte management, leads to complete recovery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkaf154","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T15:29:18Z","timestamp":1747841358000},"page":"1784-1791","source":"Crossref","is-referenced-by-count":1,"title":["Antibiotic-induced Bartter-like syndrome: a systematic review"],"prefix":"10.1093","volume":"80","author":[{"given":"Megha","family":"Priyadarshi","sequence":"first","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences , Teaching block 3rd floor, AIIMS, New Delhi ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saurav Sekhar","family":"Paul","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences , Teaching block 3rd floor, AIIMS, New Delhi ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunit","family":"Sikdar","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences , Teaching block 3rd floor, AIIMS, New Delhi ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naveet","family":"Wig","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences , Teaching block 3rd floor, AIIMS, New Delhi ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7904-4409","authenticated-orcid":false,"given":"Manish","family":"Soneja","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences , Teaching block 3rd floor, AIIMS, New Delhi ,","place":["India"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,5,21]]},"reference":[{"key":"2025070104564737800_dkaf154-B1","doi-asserted-by":"publisher","first-page":"291","DOI":"10.2147\/IJNRD.S155397","article-title":"Bartter syndrome: causes, diagnosis, and treatment","volume":"11","author":"Cunha","year":"2018","journal-title":"Int J Nephrol Renov Dis"},{"key":"2025070104564737800_dkaf154-B2","doi-asserted-by":"publisher","first-page":"1419","DOI":"10.1097\/01.ASN.0000064948.39199.A0","article-title":"Mutations in the human Na-K-2Cl cotransporter (NKCC2) identified in Bartter syndrome type I consistently result in nonfunctional transporters","volume":"14","author":"Starremans","year":"2003","journal-title":"J Am Soc Nephrol"},{"key":"2025070104564737800_dkaf154-B3","doi-asserted-by":"publisher","first-page":"55","DOI":"10.5662\/wjm.v5.i2.55","article-title":"Bartter and Gitelman syndromes: spectrum of clinical manifestations caused by different mutations","volume":"5","author":"Al Shibli","year":"2015","journal-title":"World J Methodol"},{"key":"2025070104564737800_dkaf154-B4","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.kint.2016.09.046","article-title":"Gitelman syndrome: consensus and guidance from a kidney disease: improving global outcomes (KDIGO) controversies conference","volume":"91","author":"Blanchard","year":"2017","journal-title":"Kidney Int"},{"key":"2025070104564737800_dkaf154-B5","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1681\/ASN.2021030392","article-title":"Gentamicin inhibits Ca2+ channel TRPV5 and induces calciuresis independent of the calcium-sensing receptor-claudin-14 pathway","volume":"33","author":"van Megen","year":"2022","journal-title":"J Am Soc Nephrol"},{"key":"2025070104564737800_dkaf154-B6","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1136\/bmjebm-2017-110853","article-title":"Methodological quality and synthesis of case series and case reports","volume":"23","author":"Murad","year":"2018","journal-title":"BMJ Evid Based Med"},{"key":"2025070104564737800_dkaf154-B7","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/S0272-6386(86)80012-9","article-title":"A Bartter\u2019s-like syndrome from capreomycin, and a similar gentamicin tubulopathy","volume":"7","author":"Steiner","year":"1986","journal-title":"Am J Kidney Dis"},{"key":"2025070104564737800_dkaf154-B8","doi-asserted-by":"publisher","first-page":"144","DOI":"10.4103\/1319-2442.106314","article-title":"A novel case of persistent Bartters-like syndrome associated with gentamicin exposure","volume":"24","author":"Workeneh","year":"2013","journal-title":"Saudi J Kidney Dis Transplant"},{"issue":"suppl_3","key":"2025070104564737800_dkaf154-B9","doi-asserted-by":"publisher","first-page":"iii69","DOI":"10.1093\/ndt\/gfu140","article-title":"Acquired Bartter syndrome due to streptomycin","volume":"29","author":"Nagaraju","year":"2014","journal-title":"Nephrol Dial Transplant"},{"key":"2025070104564737800_dkaf154-B10","doi-asserted-by":"publisher","first-page":"461","DOI":"10.4103\/0971-4065.177206","article-title":"Acquired Bartter syndrome following gentamicin therapy","volume":"26","author":"Singh","year":"2016","journal-title":"Indian J Nephrol"},{"key":"2025070104564737800_dkaf154-B11","doi-asserted-by":"publisher","first-page":"411","DOI":"10.3109\/0886022X.2012.761084","article-title":"Acquired Bartter-like syndrome associated with colistin use in a preterm infant","volume":"35","author":"Cakir","year":"2013","journal-title":"Ren Fail"},{"key":"2025070104564737800_dkaf154-B12","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1097\/00000441-200503000-00007","article-title":"Acquired Bartter-like syndrome associated with gentamicin administration","volume":"329","author":"Chou","year":"2005","journal-title":"Am J Med Sci"},{"key":"2025070104564737800_dkaf154-B13","doi-asserted-by":"publisher","first-page":"123","DOI":"10.3109\/0886022X.2013.832861","article-title":"Acquired Bartter-like syndrome association with netilmicin therapy in an extremely low birth weight infant","volume":"36","author":"Sandal","year":"2014","journal-title":"Ren Fail"},{"key":"2025070104564737800_dkaf154-B14","doi-asserted-by":"publisher","first-page":"822","DOI":"10.5005\/jp-journals-10071-23898","article-title":"Acquired Bartter-like syndrome presenting with polyuria and reversible hypokalemia associated with colistin use in a critically ill pediatric patient","volume":"25","author":"Yavas","year":"2021","journal-title":"Indian J Crit Care Med"},{"key":"2025070104564737800_dkaf154-B15","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1016\/S0272-6386(12)81064-X","article-title":"Acute muscular paralysis in an adult with subclinical Bartter\u2019s syndrome associated with gentamicin administration","volume":"24","author":"Shiah","year":"1994","journal-title":"Am J Kidney Dis"},{"key":"2025070104564737800_dkaf154-B16","doi-asserted-by":"publisher","first-page":"208","DOI":"10.4103\/0022-3859.57407","article-title":"Amikacin-induced type 5 Bartter-like syndrome with severe hypocalcemia","volume":"55","author":"Chrispal","year":"2009","journal-title":"J Postgrad Med"},{"key":"2025070104564737800_dkaf154-B17","first-page":"253","article-title":"Bartter-like syndrome in an adult female receiving prolonged therapy with systemic colistin","volume":"28","author":"\u00d6zdemir","year":"2020","journal-title":"Neth J Crit Care"},{"key":"2025070104564737800_dkaf154-B18","doi-asserted-by":"publisher","first-page":"739","DOI":"10.5005\/jp-journals-10071-23551","article-title":"Colistin-induced acquired Bartter-like syndrome: a rare cause of difficult weaning","volume":"24","author":"Mahendran","year":"2020","journal-title":"Indian J Crit Care Med"},{"key":"2025070104564737800_dkaf154-B19","doi-asserted-by":"publisher","first-page":"e232630","DOI":"10.1136\/bcr-2019-232630","article-title":"Colistin-induced acquired Bartter-like syndrome: an unusual cause of meltdown","volume":"13","author":"Tabish","year":"2020","journal-title":"BMJ Case Rep"},{"key":"2025070104564737800_dkaf154-B20","doi-asserted-by":"publisher","first-page":"239","DOI":"10.5005\/jp-journals-10071-24117","article-title":"Colistin-induced Bartter-like syndrome: ponder before treatment!","volume":"26","author":"Kumari","year":"2022","journal-title":"Indian J Crit Care Med"},{"key":"2025070104564737800_dkaf154-B21","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.1053\/j.ajkd.2009.07.016","article-title":"Gentamicin-induced Bartter-like syndrome","volume":"54","author":"Chen","year":"2009","journal-title":"Am J Kidney Dis"},{"key":"2025070104564737800_dkaf154-B22","doi-asserted-by":"publisher","first-page":"1962","DOI":"10.1007\/s00018-006-6011-0","article-title":"Potassium-related inherited tubulopathies","volume":"63","author":"Landau","year":"2006","journal-title":"Cell Mol Life Sci"},{"key":"2025070104564737800_dkaf154-B23","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1093\/ndt\/gfi179","article-title":"Gentamicin-induced diffuse renal tubular dysfunction","volume":"21","author":"Hung","year":"2006","journal-title":"Nephrol Dial Transplant"},{"issue":"69\u201353","key":"2025070104564737800_dkaf154-B24","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1136\/bmj.309.6953.512","article-title":"Metabolic abnormality induced by streptomycin","volume":"309","author":"Fuchs","year":"1994","journal-title":"BMJ"},{"issue":"17\u201318","key":"2025070104564737800_dkaf154-B25","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1007\/s00508-011-0011-2","article-title":"Recurrent symptomatic hypocalcemia during rifampicin therapy for brucellosis","volume":"123","author":"Torun","year":"2011","journal-title":"Wien Klin Wochenschr"},{"key":"2025070104564737800_dkaf154-B26","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1007\/s40800-017-0052-1","article-title":"Reversible hypokalemia and Bartter-like syndrome during prolonged systemic therapy with colistimethate sodium in an adult patient","volume":"4","author":"Kamal Eldin","year":"2017","journal-title":"Drug Saf Case Rep"},{"key":"2025070104564737800_dkaf154-B27","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1038\/ki.2011.400","article-title":"The case is metabolic alkalosis in a patient with cystic fibrosis","volume":"81","author":"Geara","year":"2012","journal-title":"Kidney Int"},{"key":"2025070104564737800_dkaf154-B28","doi-asserted-by":"publisher","first-page":"1975","DOI":"10.1007\/s00467-020-04822-x","article-title":"Transient Bartter-like syndrome in a child with extensively drug-resistant tuberculosis: answers","volume":"36","author":"Poojari","year":"2021","journal-title":"Pediatr Nephrol"},{"key":"2025070104564737800_dkaf154-B29","doi-asserted-by":"publisher","first-page":"6835813","DOI":"10.1155\/2017\/6835813","article-title":"Unusual complication of multidrug-resistant tuberculosis","volume":"2017","author":"Sharma","year":"2017","journal-title":"Case Rep Nephrol"},{"key":"2025070104564737800_dkaf154-B30","doi-asserted-by":"publisher","first-page":"1466","DOI":"10.36348\/sjm.2021.v06i10.003","article-title":"Acquired Bartter\u2019s syndrome\u2014a rare metabolic abnormality induced by streptomycin","volume":"11","author":"Durdana","year":"2021","journal-title":"Clin Case Rep"},{"key":"2025070104564737800_dkaf154-B31","doi-asserted-by":"publisher","first-page":"102","DOI":"10.33590\/emjnephrol\/10312410","article-title":"Prolonged intravenous colistin use associated with acquired Bartter-like syndrome in an adult patient: a case report","volume":"6","author":"Choksi","year":"2018","journal-title":"Eur Med J"},{"key":"2025070104564737800_dkaf154-B32","doi-asserted-by":"publisher","first-page":"324","DOI":"10.5152\/turkjnephrol.2019.3510","article-title":"Gentamicin-induced acquired Bartter-like syndrome: a case report and review of the literature","volume":"28","author":"Yilmaz","year":"2019","journal-title":"J Nephrol"},{"key":"2025070104564737800_dkaf154-B33","doi-asserted-by":"publisher","first-page":"646","DOI":"10.7326\/0003-4819-82-5-646","article-title":"Hypomagnesemic hypocalcemia secondary to renal magnesium wasting","volume":"82","author":"Bar","year":"1975","journal-title":"Ann Intern Med"},{"key":"2025070104564737800_dkaf154-B34","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1159\/000067797","article-title":"Aminoglycoside-induced reversible tubular dysfunction","volume":"67","author":"Alexandridis","year":"2003","journal-title":"Pharmacology"},{"key":"2025070104564737800_dkaf154-B35","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1159\/000181606","article-title":"Symptomatic hypomagnesemia associated with gentamicin therapy","volume":"23","author":"Patel","year":"1979","journal-title":"Nephron"},{"key":"2025070104564737800_dkaf154-B36","doi-asserted-by":"publisher","first-page":"1108","DOI":"10.1097\/00007611-199611000-00019","article-title":"Tetany in a child with AIDS receiving intravenous tobramycin","volume":"89","author":"Slayton","year":"1996","journal-title":"South Med J"},{"key":"2025070104564737800_dkaf154-B37","doi-asserted-by":"publisher","first-page":"79","DOI":"10.18004\/rvspmi\/2312-3893\/2018.05(02)79-084","article-title":"Pseudo Bartter syndrome associated with intravenous infusion of colistin","volume":"5","author":"Ruiz Acosta","year":"2018","journal-title":"Rev Virtual Soc Paraguaya Med Interna"}],"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/80\/7\/1784\/63265545\/dkaf154.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/80\/7\/1784\/63265545\/dkaf154.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T08:56:51Z","timestamp":1751360211000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/80\/7\/1784\/8140039"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,21]]},"references-count":37,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,5,21]]},"published-print":{"date-parts":[[2025,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dkaf154","relation":{},"ISSN":["0305-7453","1460-2091"],"issn-type":[{"value":"0305-7453","type":"print"},{"value":"1460-2091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,7]]},"published":{"date-parts":[[2025,5,21]]}}}