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To the Editor.
—In the June Archives, Kroboth et al1 described the prolonged half-life of intravenous (IV) erythromycin lactobionate in a patient receiving hemodialysis (HD) in whom hearing loss occurred. The observation of erythromycin-induced reversible deafness in three patients with chronic renal failure, one of whom was receiving HD,2,3 prompted us to study the pharmacokinetics of erythromycin in eight patients receiving HD for chronic renal failure. These eight patients were compared with ten normal control subjects.4The pharmacokinetics were studied after the patients received 1 g of oral erythromycin ethylsuccinate. The medication was given on alternate days to a dialysis session. The mean values (±SEs) of peak level (5.08±1.10 v 1.50±0.20 mg/L [P<.01]), half-life (2.65±0.42 v 1.62±0.09 hours [P<.02]), and area under the curve (20.13±5.13 v 5.66±0.32 mg/L×hr [P<.01]) were all significantly greater in the patients than in the control subjects.4 According to
Méry J, Kanfer A. Hearing Loss and Erythromycin Pharmacokinetics in Patients Receiving Hemodialysis. Arch Intern Med. 1984;144(2):419-420. doi:10.1001/archinte.1984.00350140253046