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Kanamycin dosage in renal failure.

Summary: Because kanamycin is excreted by the kidneys, its dosage must be reduced in renal failure to prevent ototoxicity. No completely satisfactory dosage schedule has been developed for this situation previously. The aim of this study was therefore to attempt to provide such a schedule to form a basis for clinical trials. 
 
 
 
Twenty studies were done in subjects with varied renal function in whom a single dose of 7.5 mg per kg body weight of kanamycin was given. The time taken for plasma kanamycin levels to fall to minimum therapeutic level was correlated with renal function as measured by plasma creatinine or the modified 15 minute urinary phenolsulphonphthalein (PSP) test. Derived linear regression relationships were used to predict the time at which a second dose was given in five further subjects with renal failure. No cumulative effect was seen in these or in another subject with renal failure treated for 23 days on the basis of the data obtained, plasma kanamycin levels remaining essentially within the therapeutic range. 
 
 
 
The data were summarized into a simple dosage table intended to serve as a clinical guide. Plasma kanamycin assay is recommended in conjunction with the use of this table. After the initial dose of 7.5 mg per kg body weight of kanamycin, it is essential to reduce all subsequent doses by 150 mg.