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Urinary Precipitate During Cephalothin-Cephaloridine Treatment

Micha Levy, MD; Marcel Eliakim, MD
JAMA. 1972;219(7):908. doi:10.1001/jama.1972.03190330066018.
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To the Editor.—  The cephalosporins are semisynthetic congeners of cephalosporin C which is produced by the fungus Cephalosporium acremonium. The most commonly used representatives of this group of new antibiotics are cephalothin sodium and cephaloridine; both are excreted unchanged in the urine.1,2 Urinary recovery studies on normal subjects given single intramuscular injections of 1.0 gm of either cephalothin sodium or cephaloridine indicate that about 75% of the injected material is eliminated in an active form during the first six hours.2 Cephaloridine is excreted almost entirely by glomerular filtration3 although tubular excretion also occurs.4 Renal dysfunction may occur during treatment with cephaloridine and, less frequently, with cephalothin.5 Acute toxic effects of cephaloridine include necrosis of the proximal convoluted tubules in mice, rats, guinea pigs, rabbits, monkeys, and man.5-9 Repeated administration in rats of 50 to 150 mg/kg/day of cephaloridine produces proteinuria,10 while moderate to large

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