Nephropathy Associated with Methicillin Administration

Summary: Nephropathy associated with the administration of methicillin and other antibiotics, occurred in four patients. High-output renal failure, hyperchloraemic acidosis and mild proteinuria were observed typically. Eosinophilia was a characteristic associated feature, and a skin rash was present in two. Recovery occurred in each case, but impairment of renal function was pro-longed. Renal biopsy performed in two patients revealed marked interstitial infiltration with mononuclear cells and eosinophils, together with patchy tubular necrosis. Follow-up renal biopsy in one patient at five months revealed residual tubular damage, interstitial cellular infiltration, and areas of interstitial fibrosis. “Methicillin kidney” appears to be a definite clinicopathological entity with features which distinguish it from other causes of renal failure in patients with severe staphylococcal infections. Because prolonged impairment of renal function may occur despite cessation of the drug, steroid therapy may be indicated during the acute phase.