GEORGE J. PAZIN, M.D.
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To the editor: When recently reviewing Bryan and Stone's excellent paper on penicillin G therapy in renal failure (Ann Intern Med 82:189-195, 1975), I noticed that penicillin clearance varies almost directly with creatinine clearance (their Figure 1). To me this suggests that the easiest way to adjust penicillin dosage in renal failure is to remember this observation and simply decrease one's usual penicillin dosage in direct proportion to the decrease in creatinine clearance. As renal insufficiency becomes worse, hepatic clearance of penicillin becomes more important, so the maximum reduction in dosage with severe renal insufficiency would be to one eighth
PAZIN GJ. Penicillin Dose and Creatinine Clearance. Ann Intern Med. ;84:754. doi: 10.7326/0003-4819-84-6-754_1
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Published: Ann Intern Med. 1976;84(6):754.
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