Two trials of oral neomycin therapy resulted in the reduction of the urinary excretion of methylmalonic acid and a fall in the plasma level of this metabolite in a child suffering from methylmalonic aciduria. It is quite probable that the antibiotic effect on the gastrointestinal bacteria resulted in decreased propionate production; propionate is the immediate precursor of methylmalonic acid. This therapy might be of special benefit during periods of acute acidosis in this disease.
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Snyderman et al. (1972) studied this question.