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JAMA. 1968;204(2):164-165.

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Although an association between weakness and k antibiotic therapy was recognized 11 years ago, reviews of the toxicity of antimicrobials do not emphasize this complication. A recent communication in the Archives of Neurology¹ surveys the English literature in this regard. It describes a "myasthenic syndrome" caused by a number of antibiotics, including neomycin, streptomycin, dihydrostreptomycin, kanamycin, polymixin, bacitracin, and colistin.

Antibiotic-induced myasthenia is characterized by flaccid paralysis, and usually is recognized at operation as prolonged apnea occurring after the intraperitoneal instillation of an antibiotic. A correlation with surgical precedures or with a particular anesthetic or relaxing agent may be more apparent than real, since the syndrome appears in many clinical settings, and is described with every conceivable route of administration. Although patients with myasthenia gravis are particularly susceptible to this effect of antibiotics, the "syndrome" as defined occurs in nonmyasthenic subjects. Distinctive features include widely dilated and fixed pupils . . . [Full Text PDF of this Article]

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