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March 17, 1945


JAMA. 1945;127(11):639-642. doi:10.1001/jama.1945.02860110019005

The view is generally held that when given by mouth penicillin is destroyed by stomach acid and in consequence only very small amounts can be detected in the urine.1 In contrast, when given by intravenous or intramuscular injection, urine recoveries of penicillin were reported to average approximately 60 per cent.1 Combined administration of penicillin and sodium bicarbonate was followed by the appearance of penicillin in the blood. The detectable levels were, however, found to be very low.2 In subjects suffering from achlorhydria accompanying pernicious anemia the urinary excretion of penicillin given by mouth reached relatively high figures with appreciable blood levels (up to 40 per cent).2

In the light of all these observations, Charney, Alburn and Bernhart3 studied penicillin excretion through the kidneys after combined administration of penicillin and buffer salts with a buffering range not reaching alkaline pH values. It is known that