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This patient's profound psychomotor agitation, prominent tremor, and marked hypertension directly contradict a state of increased neurotransmitter breakdown

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The effect of a combination of antibiotics containing vancomycin, enrofloxacin, florfenicol, and metronidazole at different doses on the gut microbiota of grass carp indicated that at higher doses (at 2 mg/fish/d except for vancomycin at 1 mg/fish/d) increased the abundance of Proteobacteria, while the abundance of Fusobacteria and the genus Cetobacterium was reduced (Sun et al., 2021)

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In 2019, a similar study recruiting 18 consecutive bedridden PEG patients who received the ED, showed one episode (5.6%) of aspiration from the trachea and no episodes of aspiration pneumonia [45]