Beta-lactams clinical toxicity

Tune BM. The renal toxicity of beta-lactam antibiotics mechanisms and clinical implications. In DeBroe ME, Porter GE, Bennett WM, et al. eds. Clinical Nephrotoxins Renal Injury from Drugs and Chemicals. Dordrecht Kluwer Academic, 1998. 

Prevention of clinical toxicity of beta-lactam antibiotics References ... 

Beta-lactams such as cephaloridine, cephalothin, ce-fotiam and imipenem have been associated with nephrotoxicity in humans and experimental animals [9]. An understanding of their nephrotoxicity mechanisms may provide valuable information for elucidation of the biochemical mechanisms of newer P-Iactam nephrotoxicity. Similarly to cephaloridine, third- generation cephalosporins such as ceftazidime and cefsulodin and fourth-generation cephalosporins such as cefpirome and cefepime possess a quaternary nitrogen attached to the dihydrothiazine ring which may impart nephrotoxic potential [10]. Clinical and animal studies carried out with P-Iactams, such as cephaloglycin, cephaloridine, cephalothin or imipenem, indicated that they show a differential accumulation at the site of their toxicity, the renal cortex [11]. Elucidation of the mechanism of toxic action of these model (i-lactams has become the focus of several research efforts [12-16]. 

C. Clinical Uses Because of its toxicity, chloramphenicol has very few uses as a systemic drug. It is a backup drug for severe infections caused by salmonella and for the treatment of pneumococcal and meningococcal meningitis in beta-lactam-sensitive persons. Some H influenzae strains are... 

---