Restrictions Imposed on Antibiotic Therapy by Renal Failure

Kunin, Calvin M.

doi:10.1001/archinte.1959.00270120186021

Cited by 97 publications

(16 citation statements)

References 74 publications

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“…These values also correspond with the results obtained by Kunin et al (1959); the metabolite half-life in normal individuals was 3.7-4.6 hours, and in the anuric 68.5-154.3 hours. The retention of these chloramphenicol metabolites raises the question of whether the glucuronide may not also exercise a toxic effect on the bone-marrow.…”

Section: Discussionsupporting

confidence: 91%

“…The inactive conjugated part is cleared by the tubuli, the rate in healthy individuals being 340 ml./minute (Glazko et al, 1949;Schtick et al, 1959). The importance of the renal function for the concentration of chloramphenicol in the blood was studied by Kunin et al (1959). They found that the concentration of active chloramphenicol in the blood was little influenced by the renal function, although the metabolites were retained if the function was impaired.…”

Section: Pharmacology Of Chloramphenicolmentioning

confidence: 99%

“…When giving antibiotic therapy, therefore, the renal function should be taken into consideration, with regard to the risk of overdose as well as the difficulty of attaining a sufficient concentration in the urine. Kunin and Finland (1959) discussed the connexion between renal function and the excretion of various antibiotics. Principally, they found that if the concentration of the substance in the blood and the volume of urine are constant, then the concentration of the substance in the urine is directly proportional to the clearance of the substance and to the renal function.…”

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confidence: 99%

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Concentration of chloramphenicol in the urine and blood in relation to renal function.

Lindberg¹,

Nilsson²,

Bucht³

et al. 1966

BMJ

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MWICAJOURNAL SummaryThe value of the anti-inflammatory and immunosuppressant actions of corticosteroids in the treatment of certain cardiac diseases is discussed. Rheumatic pancarditis, virus pericarditis and myocarditis, and the post-pericardiotomy syndrome may respond favourably, and the treatment may sometimes obviate the need for artificial pacing in complete heart-block. The use of corticosteroids in intractable cardiac oedema is also discussed.REFERENCES Aber, C. P., and Wyn Jones, E. (1960). Brit. Heart Y., 22, 723. --(1965). Ibid., 27, 916. Bayliss, R. I. S. (1959). Proc. roy. Soc. Med., 52, 929. Bengsston, E., and Orndahl, G. (1954). Acta med. scand., 149, 381. Burch, G. E., and De Pasquale, N. P. (1965) (Chittenden et al., 1949;Hewitt and Williams, 1950;Turck et al., 1962).

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Section: Discussionsupporting

confidence: 91%

Section: Pharmacology Of Chloramphenicolmentioning

confidence: 99%

mentioning

confidence: 99%

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Concentration of chloramphenicol in the urine and blood in relation to renal function.

Lindberg¹,

Nilsson²,

Bucht³

et al. 1966

BMJ

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“…The halflife of cefazolin and cephaloridine in the serum was computed by the Method of least squares (8 Table 3). The antibiotic was still detectable in the blood after 8 h in concentrations of 4.1, 2.5 and 0.9 ,ug/ml.…”

Section: Methodsmentioning

confidence: 99%

Bactericidal Activity and Pharmacology of Cefazolin

Bergeron

Brusch

Barza

et al. 1973

Antimicrob Agents Chemother

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The in vitro bactericidal activity of cefazolin was found to be similar to that of cephaloridine and cephalothin but slightly greater than that of cephalexin against a majority of 233 strains of gram-positive and gram-negative organisms. Cefazolin, however, was two-to eightfold more active than the other two drugs against Escherichia coli and klebsiella. The mean peak concentrations in the serum in 10 normal subjects 1 h after intramuscular injections of 1,000, 500, and 250 mg of cefazolin were 38.8, 18.6, and 12.2 ,g/ml, respectively. The antibiotic could still be detected at 8 h. Peak values for a given dose of cephaloridine were comparable. However, blood levels of cefazolin were regularly higher than those of cephaloridine over the first 8 h. The mean half-life of cefazolin in the serum was 2 h, whereas that of cephaloridine was 1.4 h. The degree of serum protein-binding was strikingly higher for cefazolin (81%) than for cephaloridine (24%), suggesting that the antibacterial activity of the former in serum might be less than that of cephaloridine after equal doses. This proved to be the case when the bacterial activity of blood drawn 1, 4, and 8 h after injection of the two drugs was examined.

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“…Here, doses must be adjusted in accord with the degree of renal failure. This is especially true of some antibiotics, notably streptomycin, kanamycin, vancomycin, and the tetracyclines (23).…”

Section: Conservative Managementmentioning

confidence: 99%