The Action of Some Antibiotics on the Human Intercostal Nerve-Muscle Complex

Sabawala, Phiroze B.; Dillon, John

doi:10.1097/00000542-195909000-00019

Cited by 37 publications

(9 citation statements)

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“…The role of neostigmine as an antagonist of the neuromuscular blockade induced by aminoglycoside antibiotics is of controversial value (Emery,l963,Foldes et all963,Ream,1963,Sabawala ·and Dillon, 1959,Vital-Brazil and Corrado,1957.In the present study,as in previous experiments (Paradelis et al1974) we found that neostigmine was not capable to reverse the neuromuscular blockade produced by gentamycin and kanendomycin.AII experimental and clinical data agree that the only effective antagonist is calcium chloride (Jindal and Desphande,l960,Paradelis et al1974,Vital-Brazil and Corrado,l957). …”

Section: Discussionsupporting

confidence: 57%

Pharmacology of Antibiotics

Molitor¹

1976

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Section: Discussionsupporting

confidence: 57%

Pharmacology of Antibiotics

Molitor¹

1976

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“…3 Tests on human intercostal muscles comparing the paralytic effects of multiple antibiotics, including neomycin and polymyxin B, demonstrated that polymyxin B had the strongest neuromuscular blocking activity. 4 Paralysis of the respiratory muscles in particular was described in patients receiving therapeutic doses of the polymyxins, primarily in the 1950s and early 1960s. 5 , 6 However, one review noted that there were no case reports of respiratory arrest published in the past 15 years, 7 likely because of the use of other antibiotics to treat gram-negative infections during this time period.…”

Section: Discussionmentioning

confidence: 99%

Polymyxin Use Associated With Respiratory Arrest

Wunsch

Moitra

Patel

et al. 2012

Chest

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Case 1 P atient 1 was a 48-year-old man who had a living relateddonor liver transplant for hepatic cirrhosis. His course was complicated by hospital-acquired pneumonia with initial improvement on IV vancomycin, piperacillin/tazobactam, and tobramycin. However, his condition deteriorated 2 days later, with hypotension and severe leukocytosis. An exploratory laparotomy revealed a biliary leak, and on the same day, blood cultures grew carbapenem-resistant Klebsiella pneumoniae , sensitive to polymyxin B, and with intermediate sensitivity to amikacin. Both IV amikacin and polymyxin B were initiated in consultation with the infectious diseases service. Before infusion of polymyxin B, the patient's serum creatinine level was 0.7 mg/dL and he was resting comfortably on oxygen by nasal cannula with a documented oxygen sat uration (Sa o 2 ) of 100% and a respiratory rate of 18 to 21 breaths/min. Polymyxin 125 mg (1.6 mg/kg) IV every 12 h was started. An hour after initiation of the fi rst polymyxin B infusion, he became apneic and unresponsive to sternal rub, with decreasing Sa o 2 and hypotension. He received emergency airway management including endotracheal intubation, and an infusion of epinephrine. Shortly after resuscitation, his (on an F io 2 of 100%), his sensorium was clear, and his lung mechanics were normal.Case 2 Patient 2 was a 58-year-old man with chronic renal failure who received a cadaveric renal transplant. His postoperative course was complicated by a retroperitoneal hematoma and graft rejection, treated with IV immunoglobulin and steroids, ultimately resulting in acute renal failure that required transient renal replacement therapy. He had a history of multidrug-resistant (MDR) K pneumoniae urinary tract infections sensitive to carbapenems and he received pre-and postoperative meropenem, as well as intraoperative bladder irrigation with polymyxin B. After discharge to the surgical ward, he developed a large perinephric abscess that was drained, and the fl uid culture was positive for MDR K pneumoniae , Enterococcus faecium , and Pseudomonas aeruginosa . He had been treated empirically with meropenem and tigecycline, and IV polymyxin B was added at a loading dose of 200 mg (2.9 mg/kg) IV followed by 80 mg (1.1 mg/kg) IV every 72 h because of his severe renal insuffi ciency. The day of the fourth infusion of polymyxin B, the patient's serum creatinine level was 4.6 mg/dL. Three hours after the start of the infusion the patient had acute respiratory distress. He was speaking with two physicians in his hospital room and his voice suddenly became high-pitched and he then became apneic. He received emergency airway management includ ing endotracheal intubation. An arterial blood gas drawn shortly after intubation revealed hypercapnia (pH 7.14, P co 2 65, and Pa o 2 244 on 100% F io 2 ). He did not require any vasopressor support during the respiratory arrest. The patient later recalled that at the time of the crisis he was fully aware but felt unable to breathe or move his arms. He was transferred to the I...

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“…Ikeda et al (8) studied the formation of various substituted sodium anilinomethanesulfonates in water but calculated only overall rate constants. The same investigators (9-13) also studied the amine release from different substituted anilinomethanesulfonates in water and its pH dependence.…”

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confidence: 99%