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August 21, 1967

Nephrotoxicity From Cephaloridine

JAMA. 1967;201(8):640-641. doi:10.1001/jama.1967.03130080082031

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To the Editor:—  In the article by Drs. Hinman and Wolinsky, "Nephrotoxicity Associated With the Use of Cephaloridine" (200:724, 1967), the following was reported: Klebsiella was isolated from the sputum of a patient with pneumonia; and was found to be susceptible to tetracycline, chloramphenicol, streptomycin, sulfisoxazole, kanamycin, polymyxin B and cephalothin; but was resistant to ampicillin by the disk method. By the tube dilution method, the minimum inhibitory concentration for cephaloridine was 25μg/ml.We consider this level to indicate relative resistance, and accordingly would not use cephaloridine in such a case. The patient had been previously treated with penicillin, chloramphenicol, and streptomycin, and then cephaloridine, up to 12 gm intravenously in 24 hours, was used. We do not recommend more than 4 gm daily intravenously. Sodium colistimethate was also administered. Prior to cephaloridine therapy, blood urea nitrogen levels were 13 and 23 mg/100 ml, but with this drug the