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April 23, 1949, Vol 139, No. 17 >
ARTICLE | April 23, 1949

PENICILLIN PLASMA CONCENTRATIONS: Title and subTitle BreakIncrease and Prolongation with Carinamide and Newer Depot Penicillin Preparations FREE

WILLIAM P. BOGER, M.D.; HARRISON F. FLIPPIN, M.D.
[+] Author Affiliations

Read before the Section on General Practice at the Ninety-Seventh Annual Session of the American Medical Association, Chicago, June 25, 1948.


Philadelphia

From the Philadelphia General Hospital. This work was supported in part by a grant from the Research Fund for Infectious Diseases, University of Pennsylvania.


JAMA. 1949;139(17):1131-1136. doi:10.1001/jama.1949.02900340007003
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References

Although there is considerable difference of opinion regarding the therapeutic efficacy of bactericidal concentrations of penicillin for a brief time as opposed to the maintenance of bacteriostatic concentrations for prolonged periods, it is not within the province of this paper to discuss the relative merits of these two approaches to penicillin therapy. Suffice it to say that there are authoritative proponents of both methods of treatment and there are good reasons for wishing to achieve very high levels, amounts measured in whole units of penicillin per cubic centimeter, and for maintenance of lower concentrations of a few hundredths to a few tenths of a unit per cubic centimeter for prolonged periods. It is the purpose of this paper to show how both of these requirements of therapy can be achieved.

ORAL ADMINISTRATION OF CARINAMIDE WITH PENICILLIN GIVEN INTRAMUSCULARLY  Penicillin is rapidly excreted by the

REFERENCES

1 +
Rants, L. A., and Kirby, W. M. M.:  Absorption and Excretion of Penicillin Following Continuous Intravenous and Subcutaneous Administration , J. Clin. Investigation 23:789-794, 1944;.
2 +
Jensen, K. A.; Moller, K. O., and Overgaard, K.:  Studies on the Excretion of Penicillin Through the Kidneys and the Mechanism of This Process , Acta pharmacol. et toxicol. 1: 184-206, 1945;.
3 +
Eagle, H.:  The Varying Blood Levels Afforded by Penicillins F, G, K, and X in Rabbits and Man , J. Exper. Med. 85: 163-173, 1947;.
4 +
Rammelkamp, C. H., and Bradley, S. W.:  Excretion of Penicillin in Man , Proc. Soc. Exper. Biol. & Med. 50:30-32, 1943;.
5 +
Beyer, K. H.; Woodward, R.; Peters, L. Verwey, W. F., and Mattis, P. A.:  The Prolongation of Penicillin Retention in the Body by Means of Para-Aminohippuric Acid , Science 100: 107-108, 1944;.
6 +
Carinamide is the generic name for 4'-carboxyphenylmethansulfonanalide, supplied under the trademark of staticin® by Sharp & Dohme, Inc., Glenolden, Pa. At the request of the Council on Pharmacy and Chemistry of the American Medical Association, the original designation "caronamide" has been changed to "carinamide."
7 +
Crosson, J. W.; Boger, W. P.; Shaw, C. C., and Miller, A. K.:  Caronamide for Increasing Penicillin Plasma Concentrations in Man , J. A. M. A. 134: 1528-1532 ( (Aug. 30) ) 1947;.
8 +
Boger, W. P., and Baker, R. M.:  Comparison of Effect of Caronamide and Benzoic Acid on Penicillin Plasma Concentrations , Proc. Soc. Exper. Biol. & Med. 66: 1-4, 1947;.
9 +
Seeler, A. O.; Wilcox, C., and Finland, M.:  Enhancement of Blood Levels by Caronamide During Intramuscular Administration of Penicillin , J. Lab. & Clin. Med. 32:807-817, 1947;.
10 +
Boger, W. P.; Miller, A. K.; Tillson, E. K., and Shaner, G. A.:  Caronamide; Plasma Concentrations, Urinary Recoveries and Dosage , J. Lab. & Clin. Med. 33:297-308, 1948;.
11 +
Boger, W. P., and Crosson, J. W.: The Toxicity of Carinamide: Review of 1,997 Patients, to be published.
12 +
Procaine penicillin suspended in peanut oil, duracillin,® was supplied by Eli Lilly & Company, Indianapolis 6.
13 +
The aluminum penicillinate used in this investigation was supplied by Hynson, Westcott & Dunning, Inc., Baltimore. Aluminum penicillinate is a trivalent aluminum salt and not a mixture.
14 +
This investigational material was supplied by the Medical Research Division of Sharp & Dohme, Inc., Glenolden, Pa.
15 +
Boger, W. P.; Oritt, J. E.; Israel, H. L., and Flippin, H. F.:  Procaine Penicillin G in Oil: I. Plasma Concentrations; Preliminary Observations on Its Use in Pneumonia , Am. J. M. Sc. 215:250-256, 1948;.

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1 +
Rants, L. A., and Kirby, W. M. M.:  Absorption and Excretion of Penicillin Following Continuous Intravenous and Subcutaneous Administration , J. Clin. Investigation 23:789-794, 1944;.
2 +
Jensen, K. A.; Moller, K. O., and Overgaard, K.:  Studies on the Excretion of Penicillin Through the Kidneys and the Mechanism of This Process , Acta pharmacol. et toxicol. 1: 184-206, 1945;.
3 +
Eagle, H.:  The Varying Blood Levels Afforded by Penicillins F, G, K, and X in Rabbits and Man , J. Exper. Med. 85: 163-173, 1947;.
4 +
Rammelkamp, C. H., and Bradley, S. W.:  Excretion of Penicillin in Man , Proc. Soc. Exper. Biol. & Med. 50:30-32, 1943;.
5 +
Beyer, K. H.; Woodward, R.; Peters, L. Verwey, W. F., and Mattis, P. A.:  The Prolongation of Penicillin Retention in the Body by Means of Para-Aminohippuric Acid , Science 100: 107-108, 1944;.
6 +
Carinamide is the generic name for 4'-carboxyphenylmethansulfonanalide, supplied under the trademark of staticin® by Sharp & Dohme, Inc., Glenolden, Pa. At the request of the Council on Pharmacy and Chemistry of the American Medical Association, the original designation "caronamide" has been changed to "carinamide."
7 +
Crosson, J. W.; Boger, W. P.; Shaw, C. C., and Miller, A. K.:  Caronamide for Increasing Penicillin Plasma Concentrations in Man , J. A. M. A. 134: 1528-1532 ( (Aug. 30) ) 1947;.
8 +
Boger, W. P., and Baker, R. M.:  Comparison of Effect of Caronamide and Benzoic Acid on Penicillin Plasma Concentrations , Proc. Soc. Exper. Biol. & Med. 66: 1-4, 1947;.
9 +
Seeler, A. O.; Wilcox, C., and Finland, M.:  Enhancement of Blood Levels by Caronamide During Intramuscular Administration of Penicillin , J. Lab. & Clin. Med. 32:807-817, 1947;.
10 +
Boger, W. P.; Miller, A. K.; Tillson, E. K., and Shaner, G. A.:  Caronamide; Plasma Concentrations, Urinary Recoveries and Dosage , J. Lab. & Clin. Med. 33:297-308, 1948;.
11 +
Boger, W. P., and Crosson, J. W.: The Toxicity of Carinamide: Review of 1,997 Patients, to be published.
12 +
Procaine penicillin suspended in peanut oil, duracillin,® was supplied by Eli Lilly & Company, Indianapolis 6.
13 +
The aluminum penicillinate used in this investigation was supplied by Hynson, Westcott & Dunning, Inc., Baltimore. Aluminum penicillinate is a trivalent aluminum salt and not a mixture.
14 +
This investigational material was supplied by the Medical Research Division of Sharp & Dohme, Inc., Glenolden, Pa.
15 +
Boger, W. P.; Oritt, J. E.; Israel, H. L., and Flippin, H. F.:  Procaine Penicillin G in Oil: I. Plasma Concentrations; Preliminary Observations on Its Use in Pneumonia , Am. J. M. Sc. 215:250-256, 1948;.

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