Neomycin absorption following Clagett procedure for postpneumonectomy empyema

Following a Clagett stage II procedure, significant amounts of neomycin are absorbed when concentrations of 0.25% neomycin (8.9 micrograms milliliter) are used. If higher concentrations are employed, the neomycin can achieve toxic levels (40 micrograms per milliliter), with associated renal toxicity and respiratory suppression. The peel of the empyema cavity does not prevent absorption of drugs. Therefore, when drugs are inserted into an empyema cavity, due care must be exerted to prevent drug toxicity.