Antibiotic concentrations in the urine from kidneys of unequal function.
Little attention has been given to whether an effective concentration of an antibiotic is obtained in the urine of a patient without azotemia who has one poorly functioning kidney and a contralateral normal kidney. This study was undertaken to measure the concentration of various antibiotics in the urine from both kidneys of 20 patients with unilateral renal disease and a radiologically and functionally normal contralateral kidney. Prior to ureteric catheterization each patient received a single parenteral dose of an antibiotic. The peak urinary drug concentration from the damaged kidney per unit of its creatinine clearance exceeded that for the normal kidney for 11/13 patients treated with an aminoglycoside and 6/7 given a cephalosporin. The most severely damaged kidney had a creatinine clearance of 0.6 ml/min. This patient received sisomicin and the peak urinary concentration was only 1.8 micrograms/ml. If a damaged kidney has a creatinine clearance less than 10-15 ml/min it would seem more appropriate to use a cephalosporin rather than an aminoglycoside antibiotic.
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000652:urine*; D002437:Cefazolin / Q000652:urine; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000652:urine*; D008297:Male; D009428:Netilmicin / Q000652:urine; D012853:Sisomicin / Q000652:urine; D014031:Tobramycin / Q000652:urine
D000900:Anti-Bacterial Agents; D009428:Netilmicin; D002437:Cefazolin; D014031:Tobramycin; D012853:Sisomicin