PERSISTENCE OF ANTIBIOTICS IN BLOOD OF PATIENTS WITH ACUTE RENAL FAILURE. III. PENICILLIN, STREPTOMYCIN, ERYTHROMYCIN AND KANAMYCIN*†

Abstract

In the preceding papers, one dealing with tetra- cycline and chlortetracycline (2) and the other with chloramphenicol (3), the circumstances under which these drugs would be expected to accumulate in the blood of patients with renal failure were indicated. Dosage regimens were outlined which took into account the limitations imposed by renal disease on the elimination of these drugs. The present report presents the re- sults of studies on the persistence of four addi- tional antibiotics; penicillin, streptomycin, erythro- mycin and kanamycin, following their administra- tion to patients with severe renal failure. Since anuria may be considered to represent the maxi- mum impairment of renal function as seen in man, emphasis was placed on the study of patients in this state in determining the maximum contribu- tion of nonrenal factors toward the elimination or inactivation of these drugs under the physiological limitations of uremia. The findings should prove helpful in delineating the optimum dosage regi- mens for these drugs in patients with markedly impaired renal function.