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A New Antibiotic you may need to be Aware of

Dr David Hilton-Jones

Oxford

Many readers will know that some drug treatments can make myasthenia worse. Amongst the commonest are certain antibiotics. If the myasthenia is well controlled, they rarely cause problems; if it is not, they can do so, especially if a myasthenic crisis has been brought on by an infection and one of these antibiotics has been used to treat it. With most drugs, only a minority of patients reacts badly.

Another name has now been added to the list of drugs reported to worsen myasthenia. Aventis, the manufacturers of Telithromycin (Ketekâ), have informed health professionals about this new antibiotic (the first of a group of antibiotics called ketolides).

There have been several reports of it worsening myasthenia, including one fatal case. Obviously, its use should be avoided in all patients with myasthenia wherever one can. Just possibly, however, it may be the only antibiotic to which a resistant infection is sensitive. In such an unusual case, the drug will have to be used, but with extremely close monitoring of the patient for any downturn, particularly in the breathing muscles.

MGA NEWS Summer 2003