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July 1967

Neurotoxicity and "Massive" Intravenous Therapy With Penicillin: A Study of Possible Predisposing Factors

Author Affiliations


From the Infectious Disease Service of the New England Medical Center Hospitals and the Department of Medicine, Tufts University School of Medicine, Boston.

Arch Intern Med. 1967;120(1):47-53. doi:10.1001/archinte.1967.00300010049008

THE USE of very large doses of penicillin for the treatment of "resistant" infections has received only sporadic attention and has, for the most part, been limited to the management of instances of bacterial endocarditis which failed to respond to a variety of other antibiotics.1,2 In 1964, Weinstein and his associates3 recorded favorable results in 15 to 17 patients treated with 20 to 60 million units of penicillin G per day intravenously for severe infections due to gram-negative organisms that, by conventional methods of testing, were considered to be insensitive to the drug. They pointed out that generalized epileptiform seizures occurred in one instance and appeared to be unequivocally related to the large dose of the antibiotic. Convulsions noted in two other cases, not included in the other 17, were also apparently related to the use of excessive quantities of the antibiotic.

The purpose of the present investigation