October 16, 1967

Nephrotoxicity of Antibiotics

Author Affiliations

From the departments of preventive medicine and medicine, University of Virginia School of Medicine, Charlottesville.

JAMA. 1967;202(3):204-208. doi:10.1001/jama.1967.03130160078015

The potentially nephrotoxic antibiotics in current clinical use are neomycin, kanamycin, paromomycin, bacitracin, the polymyxins (polymyxin B, and colistin), and amphotericin B.1-3 Nephrotoxicity was reported with early lots of streptomycin, but the drug now commercially available does not appear to have this property. Fortunately, the nephrotoxicity of each of these drugs appears to be reversible provided their administration is stopped soon enough. Patients with underlying renal disease appear to be particularly sensitive to most of these agents. This sensitivity may be attributable in part to the tendency of these drugs to accumulate rapidly in the blood of uremic patients given ordinary therapeutic doses and in part to the diminished renal functional reserve of uremic patients. Tetracycline may now be added to the group of potentially nephrotoxic drugs, because a reversible Fanconi-like syndrome produced by preparations containing degraded tetracycline has been observed.

Tetracyclines.—  A primary renal toxic effect of undegraded