ANDREW WHELTON, M.D.; GORDON G. CARTER, A.B.; HENRY H. BRYANT, M.S.; L. ARLENE PORTEOUS, B.S.; W. GORDON WALKER, M.D., F.A.C.P.
Renal tissue concentrations of carbenicillin and its intrarenal distribution are markedly influenced by alterations in the physiologic activity of the normal kidney or by the presence of severe disease in the renal parenchyma. In the hydropenic state, cortical, papillary, and urinary levels may be as much as 3, 17½, or 535 times greater, respectively, than the concomitant serum level. Hydration abolishes this increased cortico-papillary-urinary gradient pattern. Severe disease in human kidneys markedly decreases the renal parenchymal penetration of carbenicillin and significantly reduces the urine concentrations. This decreased renal tissue concentration averages 4 to 14 times less than the concentration in normal renal tissue. These changes in the renal and urinary pharmacokinetics of carbenicillin, in health and disease, have not been previously defined; they must be taken into account in the therapy of pyelonephritis and urinary tract infections.
WHELTON A, CARTER GG, BRYANT HH, PORTEOUS LA, WALKER WG. Carbenicillin Concentrations in Normal and Diseased Kidneys: A Therapeutic Consideration. Ann Intern Med. ;78:659–662. doi: 10.7326/0003-4819-78-5-659
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Published: Ann Intern Med. 1973;78(5):659-662.
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