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Therapeutic Implications of Gentamicin Accumulation in Severely Diseased Kidneys
Andrew Whelton, MD;
Gordon G. Carter;
Henry H. Bryant, MS;
Louis Fox, MD;
W. Gordon Walker, MD
Arch Intern Med. 1976;136(2):172-176.
Abstract
We evaluated the influence of severe disease in human kidneys (12 patients) on gentamicin sulfate accumulation characteristics in such tissue and compared the results with intrarenal tissue concentration data derived from the study of healthy dogs (54 kidneys) during variation in hydration and urinary pH.
Our results indicate that, in the management of pyelonephritis complicating preexisting renal disease, if the minimal inhibitory gentamicin concentration for an infecting organism is greater than the usual therapeutic and nontoxic serum levels of the compound, then it may be appropriate to use alternate antibiotics that demonstrate lesser reduction in tissue drug accumulation in diseased kidneys.
(Arch Intern Med 136:172-177, 1976)
Author Affiliations
From the O'Neill Research Laboratories of the Department of Medicine, Johns Hopkins University School of Medicine, the Johns Hopkins Hospital, Baltimore, and the National Center for Antibiotic Analysis, Food and Drug Administration, US Department of Health, Education, and Welfare, Washington, DC.
Footnotes
Received for publication April 9, 1975; accepted May 23.
Presented in part at the fourth annual meeting of the American College of Clinical Pharmacology, Atlantic City, NJ, May 2-3, 1975.
Reprint requests to Renal Division, the Johns Hopkins Hospital, Baltimore, MD 21205 (Dr Whelton).
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