Unintentional human exposure to tilmicosin (Micotil 300).
BACKGROUND
Tilmicosin phosphate is a macrolide antibiotic that is used to treat cattle for pathogens that cause Bovine Respiratory Disease.


METHODS
A 28-year-old man with no prior history of heart disease developed severe chest pain, inverted T waves, and intraventricular conduction delay on EKG and mild elevation of cardiac enzymes 5 hours after unintentional injection of less than half of a 12cc syringe filled with Micotil 300 (tilmicosin phosphate 300 mg/mL, propylene glycol 25%, phosphoric acid, water for injection). The patient made an uneventful recovery after hospitalization.


CONCLUSIONS
This case provides evidence that unintentional injection of tilmicosin can cause cardiac symptoms and laboratory evidence of myocardial injury. Tilmicosin should always be administered by properly trained personnel who are using techniques designed to reduce the risk of accidental self-injection.
Von Essen
Susanna
S
University of Nebraska Medical Center, Omaha, Nebraska 68198-5300, USA.
Spencer
Jonathan
J
Hass
Brian
B
List
Pam
P
Seifert
Steven A
SA
D000062:Accidents, Occupational; D000328:Adult; D000822:Animal Husbandry; D000900:Anti-Bacterial Agents / Q000506:poisoning*; D002637:Chest Pain / Q000139:chemically induced*; D004562:Electrocardiography; D006801:Humans; D007267:Injections; D018942:Macrolides; D008297:Male; D015645:Tylosin / Q000031:analogs & derivatives* / Q000506:poisoning*; D019155:Veterinary Drugs / Q000506:poisoning*
D000900:Anti-Bacterial Agents; D018942:Macrolides; D019155:Veterinary Drugs; C052319:tilmicosin; D015645:Tylosin