Clinical indications for the use of ristocetin are infections due to gram-positive organisms. With most organisms ristocetin has a bactericidal effect at about the same concentration at which it is bacteriostatic. This fact may be responsible for its clinical efficacy. In its present form, ristocetin is administered only intravenously, since it is painful and poorly absorbed when given intramuscularly, and is ineffective orally. The dosage for the majority of staphylococcic infections is 25 mg. per kilogram of body weight daily. Since the antibiotic is excreted mainly via the kidneys, it should be administered with caution in patients with renal impairment. Leukopenia and neutropenia have been reported as complications of ristocetin therapy. In all cases, there should be a frequent determination of blood cell count, with particular reference to the total leukocytes and the percentage of polymorphonuclear neutrophils.
Calvy GL, Schumacher LR. RISTOCETIN AND THE STAPHYLOCOCCUS: OBSERVATIONS OF EFFECTS AND SIDE-EFFECTS IN SEVENTEEN CASES OF STAPHYLOCOCCIC PNEUMONIA. JAMA. 1958;167(13):1584–1586. doi:10.1001/jama.1958.02990300010002
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