The effect of colymycin M, gentamycin and kanamycin on depression of neuromuscular transmission induced by pancuronium bromide.

THE INTERACTION Of antibiotics and neuromuscular blocking agents has been well documented. Neomycin, a.-~ streptomycin, 3 kanamycin, 3 gentamicin, 4'~ bacitraein, G polymyxin B ~ and colymicin ~ have been shown to potentiate the neuromuscular blockade of d-tubocurarine. The combined action of the muscle relaxant and the antibiotic is often resistant to reversal by both calcium '2,~3,~4 and neostigmine. 12,~5 Administration of d-tubocurarine is often followed by hypotension due to histamine release or ganglionic blockade. Pancuronium bromide is a new non-depolarizing muscle relaxant recently introduced to clinical anaesthesia. It has been found to be free of the adverse effects attributed to d-tubocurarine. However, two clinical reports published recently have shown that kanamycin s and polymiein B 7 are capable of prolonging the neuromuscular blockade caused by this new agent. Repeated doses of calcium and neostigmine could not reverse the paralysis. The purpose of this study was to exanaine the effect of three members of the mycin group of antibiotics on depression of neuromuscular transmission induced by pancuronium bromide. The agents were administered intravenously to dogs in maximal daily doses recommended for humans. It was the aim of the study to produce a state of partial neuromuscular blockade with pancuronium bromide and then to determine the effect of addition of the test antibiotic on the preexisting blockade. The antibiotics tested were colymycin (Warner Chilcott Laboratory), gentamycin (Schering) and kanamycin (Bristol).