Intraperitoneal Neomycin as a Cause of Apnea

Since the discovery of neomycin by Waksman in 1949,¹ this antibiotic has been found useful in the prophylaxis and treatment of intra-abdominal infections. Poth² and others^3,4 demonstrated the effectiveness and safety of neomycin sulfate used orally as an intestinal antiseptic prior to bowel surgery. More recently, intraperitoneal instillation has been advocated in the treatment of peritonitis.^5,6 Neomycin has also been given as prophylaxis against the complications associated with soilage of the peritoneal cavity. Pridgen⁷ in 1956 and Engel et al.⁸ in 1957 each reported four cases of respiratory arrest associated with neomycin administered intraperitoneally. Another case is reported in the case section of the American Society of Anesthesiologists' Newsletter.⁹ Ferrara et al.,¹⁰ Webber,¹¹ Middleton et al.,¹² and Doremus¹³ reported six additional cases. At this time we are aware of 16 patients including the one presented in this paper who