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Human exposures to tilmicosin reported to poison centres, Texas, 1998-2003

Epidemiology and Disease Surveillance Unit, Texas Department of State Health Services, 1100 W 49th Street, Austin, TX 78756, USA mathias.forrester{at}dshs.state.tx.us

Tilmicosin, or 20-deoxo-20-(3,5-dimethylpiperidin-1-yl)desmycosin, is a macrolide antibiotic primarily utilized in livestock. This study examined 46 human exposure calls involving tilmicosin received by Texas poison centres during 1998 - 2003. The majority (91%) of the calls were received from northern and central Texas. All of the cases were unintentional exposures. The most frequent route of exposure was parenteral (48%). The majority of the patients were males (80%) and adults (84%). Only 46% of the patients were managed outside of health care facilities. Some sort of adverse medical outcome was reported in 93% of parenteral exposures and 54% of other-route exposures. However, only 21% of parenteral exposures and 15% of other-route exposures involved medical outcomes that were judged to be moderate or worse. No deaths were reported. The most frequently reported clinical effects among parenteral cases were dermal (79%), while only 9% of other-route exposures had dermal effects. Cardiovascular clinical effects were observed in a single case of parenteral exposure and a single case of other-route exposure. Although the majority of cases were managed with the assistance of health care facilities, the medical outcomes were usually not serious. Outcome depended on the route of exposure.

Key Words: antibiotic • icotil® • oison centre • tilmicosin

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