The half-life (T /2) of penicillin in blood was determined in 61 patients. An inverse relationship of penicillin T/2 and endogenous creatinine clearance was found. In a group of elderly patients with normal serum creatinine, penicillin T/2 was prolonged due to age-dependent decrease in renal function. The effect of several drugs on the active renal tubular transport mechanism of penicillin was studied. Probenecid increased penicillin T/2 from an average of 40.4 to 104.3 minutes. Penicillin T/2 in the younger patients using probenecid was of the same order as penicillin T/2 in elderly individuals not using probenecid. Phenylbutazone increased penicillin T/2 almost as much as did probenecid. Sulfinpyrazone, acetylsalicylic acid, indomethacin, and sulfaphenazole in therapeutic doses increased penicillin T /2 to a smaller degree. There was no significant change in penicillin T /2 after therapeutic doses of chlorothiazide, sulfamethizole, and sulfamethoxypyridazine.Recently a relationship between penicillin half-life ( T /2), glomerular filtration rate, and para-aminohippuric acid ( PAH) clearance was demonstrated. 12 Many acidic drugs are secreted by the same proximal tubular active transport mechanism as penicillin, but only probenecid and the phenylbutazones have been shown to reduce the rate of renal excretion of penicillin in man. 2 • 3 • 9 Lengthening the penicillin halflife might enhance the therapeutic effect, but it might also increase certain risksY This investigation was undertaken to study the relationship between penicillin T /2 in blood and age-dependent changes in renal
The clinical effects of treatment with a trimethoprim (TMP)-sulphamethoxazole (SM) combination were studied in 40 patients with urinary tract infection. The indication for treatment was symptoms of urinary tract infection with > 10(5) colonies per ml of urine. The dosage was 160 mg of TMP and 800 mg of SM administered orally twice daily for 10 days. The bacteriological in vitro examination revealed synergic effect of the two agents on 30 out of 55 bacterial strains (55%). Out of 32 strains which were resistant or slightly sensitive to SM, synergy was revealed in 14 instances (44%). Development of resistance to TMP was seen in one case. In 20 patients with non-complicated urinary tract infections, sterile urine was found 3 and 14 days after termination of treatment in 100% and 89%, respectively. In one case there was recurrence, and in one case reinfection occurred. In 20 patients with complicated urinary tract infections, sterile urine was found 3 and 14 days after termination of treatment in 80% and 55%, respectively. In 4 cases infection recurred, and in 5 cases the treatment had no effect. Side effects were seen in 3 patients; one case of exanthem, one of nausea, and one of leucopenia. In one case treatment had to be withdrawn because of exanthem, in another because of nausea.
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