Reversible Respiratory Paralysis Associated with Polymyxin Therapy

Respiratory paralysis is a potentially fatal, though reversible, complication of the use of polymyxin B and colistimethate (polymyxin E) in patients with renal disease. Clinical findings in 11 cases of reversible respiratory paralysis associated with polymyxin therapy are reviewed and their management discussed. A relationship between the neuromuscular toxicity of these drugs and underlying renal disease is emphasized. Previously reported cases in the literature are summarized, and possible mechanisms producing neuromuscular blockade are discussed.