Unintentional Human Exposure to Tilmicosin (Micotil^®300)

Abstract

Background. Tilmicosin phosphate is a macrolide antibiotic that is used to treat cattle for pathogens that cause Bovine Respiratory Disease. Case Report. 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 12 cc 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.