This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Miscellaneous (Pharmacology), Subject name: Pharmacology
Which one of the following does NOT increase neuromuscular blockade? 
Select and explain. 
A. Clindamycin, B. Lincomycin, C. Streptomycin, D. Erythromycin
D: Erythromycin
Answer: D: Erythromycin 
Explanation: (D) Erythromycin # NEUROMUSCULAR BLOCKADE CAUSED BY AMINOGLYCOSIDES: An unusual toxic reaction of acute neuromuscular blockade and apnea has been attributed to the aminoglycosides. Order of decreasing potency for blockade is Neomycin, Kanamycin, Amikacin, Gentamicin, and Tobramycin. In humans, neuromuscular blockade generally has occurred after intrapleural or intraperitoneal instillation of large doses of an aminoglycoside; Most episodes have occurred in association with anesthesia or the administration of other neuromuscular blocking agents Patients with myasthenia gravis are particularly susceptible to neuromuscular blockade by aminoglycosides Erythromycin does not cause nueromuscular blockade as it is a macrolide.