A 70-year-old man with myasthenia gravis received a single intramuscular injection of colistimethate sodium (150 mg) for a urinary tract infection. He developed a respiratory arrest with a complete flaccid paralysis three hours later. All muscles but those associated with respiration improved rapidly following intramuscular neostigmine methylsulfate (2 mg) and intravenous edrophonium chloride (10 mg) administration. A combination of ventilation support and anticholinesterase therapy brought about recovery in 11 days. Carbenicillin effectively eradicated the Pseudomonas infection without causing neuromuscular impairment.
Decker DA, Fincham RW. Respiratory Arrest in Myasthenia Gravis With Colistimethate Therapy. Arch Neurol. 1971;25(2):141–144. doi:10.1001/archneur.1971.00490020059006
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