Persistence of Antibiotics in Blood of Patients With Acute Renal Failure. Ii. Chloramphenicol and Its Metabolic Products in the Blood of Patients With Severe Renal Disease or Hepatic Cirrhosis*†

lt is known that the kidney plays a major but variable role in the elimination of most of the antibiotics that are used systemically. Since these drugs are often employed in the prevention and treatment of infections in patients with severe renal disease, it becomes essential, both for the choice of agents and for their most effective use, to know how the different antibiotics are handled by the patient with impaired renal function. The present series of studies was therefore under- taken with a view to providing a basis for the rational choice of antibiotics and their dosage in such patients. The persistence of several other commonly used antibiotics in the blood of pa- tients with anuria and severe renal impairment was described in other papers of this series (2, 3). This paper is concerned with the overall metabo- lism of chloramphenicol in similar patients. In addition, since the liver is also involved in the metabolism of chloramphenicol, studies in a few patients with severe hepatic cirrhosis are also included.