Lactic acidosis, hyperglycaemia and convulsions following nalidixic acid overdosage

A woman survived ingestion of 32 g nalidixic acid despite developing lactic acidosis, hyperglycaemia, convulsions and abnormal behaviour. The maximum recorded plasma concentration of nalidixic acid was 185 mg/l and the elimination half-life was 3.2 h. Carboxy-nalidixic acid was demonstrated in the plasma. Previously reported cases of nalidixic acid overdosage are reviewed.