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Antibiotics: The Experimental and Clinical Situation

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Nephrotoxicity in the experimental and clinical situation

Part of the book series: Developments in Nephrology ((DINE,volume 19-20))

Abstract

This chapter will review information gained from animal experiments to help prevent and manage antibiotic nephrotoxicity in humans. The comparison is based on the effects of aminoglycosides on animals, normal human volunteers and patients being treated for infection. These data have been used to highlight the problem of studying nephrotoxicity in patients with severe infections and highlight the need for research into more realistic animal models.

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References

  1. Kaloyanides, G.J. and Pastoriza-Munoz, E., Aminoglycoside nephrotoxicity, Kidney Int., 18, 571, 1980.

    Article  PubMed  CAS  Google Scholar 

  2. Parker, R.A., Bennett, W.M. and Porter, G.A., Animal models in the study of aminoglycoside nephrotoxicity, in The Aminoglycosides. Microbiology, Clinical Use and Toxicology, Whelton, A. and Neu, H.C., Eds., Marcel Dekker, New York, 1982, 235.

    Google Scholar 

  3. Appel, G.B., Aminoglycoside nephrotoxicity: physiologic studies of the sites of nephron damage, in The Aminoglycosides. Microbiology, Clinical Use and Toxicology, Whelton, A. and Neu, H.C., Eds., Marcel Dekker, New York, 1982, 269.

    Google Scholar 

  4. Kaloyanides, G.J., Aminoglycoside-induced functional and biochemical defects in the renal cortex, Fund. Appl. Toxicol., 4, 930, 1984.

    Article  CAS  Google Scholar 

  5. Walenkamp, G., Vree, T., Guelen, P. and Jongman-Nix, B., Interaction between the renal excretion rates of ß2-microglobulin and gentamicin in man, Clin. Chim. Acta, 127, 229, 1983.

    Article  PubMed  CAS  Google Scholar 

  6. Mondorf, A.W. and Schoeppe, W., Is the potential nephrotoxicity of drugs predictable? Experiences with a volunteer model, Contr. Nephrol., 42, 93, 1984.

    CAS  Google Scholar 

  7. Davey, P.G., Geddes, A.M. and Cowley, D.M., Study of alanine amino peptidase excretion as a test of gentamicin nephrotoxicity, J. Antimicrob. Chemother., 11, 455, 1983.

    Article  PubMed  CAS  Google Scholar 

  8. Schentag, J.J., Specificity of renal tubular damage for aminoglycoside neph-rotoxicity in critically ill patients, J. Clin. Pharmacol., 23, 473, 1983.

    PubMed  CAS  Google Scholar 

  9. Davey, P.G., Cowley, D.M., Geddes, A.M. and Terry, J., Clinical evaluation of ß2-microglobulin, muramidase, and alanine aminopeptidase as markers of gentamicin nephrotoxicty, Contr. Nephrol., 42, 100, 1984.

    CAS  Google Scholar 

  10. Donta, S.T. and Lembke, L.A., Comparative effects of gentamicin and tobramycin on excretion of N-acetyl-ß-glucosaminidase, Antimicrob. Agents Chemother., 28, 500, 1985.

    PubMed  CAS  Google Scholar 

  11. Schwartz, J.H. and Scheni, P., Fanconi syndrome associated with cephalothin and gentamicin therapy, Cancer, 41, 769, 1978.

    Article  PubMed  CAS  Google Scholar 

  12. Russo, J.C. and Adelman, R.D., Gentamicin-induced Fanconi syndrome, J. Pediatr., 96, 151, 1980.

    Article  PubMed  CAS  Google Scholar 

  13. Ginsburg, D.S., Quintanilla, A.P. and Levin, M., Renal glycosuria due to gentamicin in rabbits, J. Infect. Dis., 134, 119, 1976.

    Article  PubMed  CAS  Google Scholar 

  14. Chahwala, S.B. and Harpur, E.S., Gentamicin-induced hypercalciuria in the rat, Acta Pharmacol. Toxicol., 53, 358, 1983.

    Article  CAS  Google Scholar 

  15. Chiu, P.J.S., Miller, G.H., Brown, A.D., Long, J.F. and Waitz, J.A., Renal pharmacology of netilmicin, Antimicrob. Agents Chemother., 821, 1977.

    Google Scholar 

  16. Cronin, R.E., Bulger, R.E, Southern, P. and Henrich, W.L-, Natural history of aminoglycoside nephrotoxicity in the dog, J. Lab. Clin. Med., 95, 463, 1980.

    PubMed  CAS  Google Scholar 

  17. Kluwe, W.M. and Hook, J.B., Functional nephrotoxicity of gentamicin in the rat, Toxicol. Appl. Pharmacol., 45, 163, 1978.

    Article  PubMed  CAS  Google Scholar 

  18. Appel, G.B., Siegel, N.J., Apel, A.S. and Hayslett, J.P., Hemodynamic and tubular functional alterations in gentamicin induced experimental acute renal failure, Kidney Int., 14, 72, 1978.

    Google Scholar 

  19. Kluwe, W.M. and Hook, J.B., Analysis of gentamicin uptake by rat renal cortical slices, Toxicol. Appl. Pharmacol., 45, 531, 1978.

    Article  PubMed  CAS  Google Scholar 

  20. Zaloga, G.P., Chernow, B., Pock, A., Wood, B. and Zaritsky, A., Hypomagnesemia is a common complication of aminoglycoside therapy, Surg. Gynaecol. Obstet., 158, 561, 1984.

    CAS  Google Scholar 

  21. Davey, P., Gozzard, D., Goodall, M. and Leyland, M.J., Hypomagnesaemia: an underdiagnosed interaction between gentamicin and cytotoxic chemotherapy for acute non-lymphoblastic leukaemia, J. Antimicrob. Chemother., 15, 623, 1985.

    Article  PubMed  CAS  Google Scholar 

  22. Keating, M.J., Sethi, M.R., Bodey, G.P. and Samaan, N.A., Hypocalcemia with hypoparathyroidism and renal tubular dysfunction associated with aminoglycoside therapy, Cancer, 29, 1410, 1977.

    Article  Google Scholar 

  23. Mitchell, C.J., Bullock, S. and Ross, B.D., Renal handling of gentamicin and other antibiotics by the isolated perfused rat kidney: mechanism of nephrotoxicity. J. Antimicrob. Chemother., 3, 593, 1977.

    Article  PubMed  CAS  Google Scholar 

  24. Pastoriza, E., Timmerman, D. and Kaloyanides, G.J., Tubular wasting of cations associated with netilmicin infusion, Clin. Res., 31, 438, 1983.

    Google Scholar 

  25. Bennett, W.M., McDougall, J., Potocnik, S., Wright, R.D. and Whitworth, J.A., Renal handling and acute urinary electrolyte effects of aminoglycoside antibiotics: use of a solitary renal autotransplant in the conscious sheep, Life Sci., 32, 205, 1983.

    Article  PubMed  CAS  Google Scholar 

  26. Harpur, E.S., Fathalla, S.A.K. and Phipps, D.J., Increased urinary excretion of calcium and magnesium is an early manifestation of gentamicin-induced nephrotoxicity in the rat, in Renal Heterogeneity and Target Cell Toxicity, Bach, P.H. and Lock, E.A., Ed., John Wiley & Sons, Chichester, 1985, 349.

    Google Scholar 

  27. Foster, J.E. and Harpur, E.S., Infusion of gentamicin increases renal clearance of calcium and magnesium in Fischer 344 rats, Br. J. Pharmacol., 88, 428, 1986.

    Google Scholar 

  28. Foster, J.E. and Harpur, E.S., Infusion of gentamicin increases renal clearance of calcium and magnesium in Fischer 344 rats, Br. J. Pharmacol., 88, 428, 1986.

    Google Scholar 

  29. Finton, C.K., Bjorkland, R.N., Zaloga, G.P., Uddin, D.E. and Chernow, B., Gentamicin-induced hypomagnesemia, Am. Surg., 49, 576, 1983.

    PubMed  CAS  Google Scholar 

  30. Cronin, R.E., Nix, K.L., Ferguson, E.R., Southern, P.M. and Henrich, W.L., Renal cortex ion composition and Na-K-ATPase activity in gentamicin nephrotoxicity, Am. J. Physiol., 242, F477, 1982.

    PubMed  CAS  Google Scholar 

  31. Weinberg, J.M., Harding, P.G. and Humes, D., Alterations in renal cortex cation homeostasis during mercuric chloride and gentamicin nephrotoxicity, Exp. Mol. Pathol., 39, 43, 1983.

    Article  CAS  Google Scholar 

  32. Brinker, K.R., Bulger, R.E., Dobyan, D.C., Stacey, T.R., Southern, P.M., Henrich, W.L. and Cronin, R.E., Effect of potassium depletion on gentamicin nephrotoxicity, J. Lab. Clin. Med., 98, 292, 1981.

    PubMed  CAS  Google Scholar 

  33. Rankin, L.I., Krous, H., Fryer, A.W. and Whang, R., Enhancement of gentamicin nephrotoxicity by magnesium depletion in the rat, Miner. Electrolyte Metab., 10, 199, 1984.

    CAS  Google Scholar 

  34. Quarum, M.L., Houghton, D.C., Gilbert, D.N., McCarron, D.A. and Bennett, W.M., Increasing dietary calcium moderates experimental gentamicin nephrotoxicity, J. Lab. Clin. Med., 103, 104, 1984.

    PubMed  CAS  Google Scholar 

  35. Patel, R. and Savage, A., Symptomatic hypomagnesemia associated with gentamicin therapy, Nephron, 23, 50, 1979.

    Article  PubMed  CAS  Google Scholar 

  36. Shils, M.E., Experimental human magnesium depletion, Medicine, 48, 61, 1969.

    Article  PubMed  CAS  Google Scholar 

  37. Bar, R.S., Wilson, H.E. and Mazzaferri, E.L., Hypomagnesemia hypocalcemia secondary to renal magnesium wasting; a possible consequence of high-dose gentamicin therapy, Ann. Intern. Med., 82, 646, 1975.

    PubMed  CAS  Google Scholar 

  38. Bamford, M.F.M. and Jones, L.F., Deafness and biochemical imbalance after burns treatment with topical antibiotics in young children, Arch. Dis. Child., 53, 326, 1978.

    Article  PubMed  CAS  Google Scholar 

  39. Mountokalakis, T., Tzouvelekis, E. and Mayopoulou-Symvoulidou, D., Effects of gentamycin on renal magnesium excretion, in Magnesium Deficiency, Hal- pern, M.J. and Durlach, J., Eds. First Eur. Cong. Magnesium, Karger, Basel, 1985.

    Google Scholar 

  40. Holmes, A.M., Hesling, C.M. and Wilson, T.M., Drug-induced secondary hyper- aldosteronism in patients with pulmonary tuberculosis, Q. J. Med., 39, 299, 1970.

    CAS  Google Scholar 

  41. Kelnar, C.J.H., Taor, W.S., Reynolds, D.J., Smith, D.R., Slavin, B.M. and Brook, C.G.D., Hypomagnesaemic hypocalcaemia with hypokalaemia caused by treatment with high dose gentamicin, Arch. Dis. Child., 53, 817, 1978.

    Article  PubMed  CAS  Google Scholar 

  42. Goodhart, G.L. and Handelsman, S., Gentamicin and hypokalemia, Ann. Intern. Med, 103, 645, 1985.

    PubMed  CAS  Google Scholar 

  43. Davies, S.V. and Murray, J.A., Amphotericin B, aminoglycosides and hypomag- nesaemic tetany, Br. Med. J., 292, 1395, 1986.

    Article  CAS  Google Scholar 

  44. Wilkinson, R., Lucas, G.L., Heath, D.A., Franklin, I.M. and Boughton, B.J., Hypomagnesaemic tetany associated with prolonged treatment with aminoglycosides, Br. Med. J., 292, 818, 1986.

    Article  CAS  Google Scholar 

  45. Freedman, D.B., Shannon, M., Dandona, P., Prentice, H.G. and Hoffbrand, A.V., Hypoparathyroidism and hypocalcaemia during treatment for acute leukaemia, Br. Med. J., 284, 700, 1982.

    Article  CAS  Google Scholar 

  46. Afzal Mir, M. and Delamore, I.W., Metabolic disorders in acute myeloid leukaemia, Br. J. Haematol., 40, 79, 1978.

    Article  Google Scholar 

  47. Cronin, R.E. and Knochel, J.P., Magnesium deficiency, Arch. Intern. Med., 28, 509, 1983.

    CAS  Google Scholar 

  48. Thompson, C.B., June, C.H., Sullivan, K.M. and Donnall Thomas, E., Association between cyclosporin neurotoxicity and hypomagnesaemia, Lancet, 1116, 1984.

    Google Scholar 

  49. Gary, N.E., Buzzeo, L., Salaki, J. and Elsinger, R.P., Gentamicin-associated acute renal failure, Arch. Intern. Med., 136, 1101, 1976.

    Article  PubMed  CAS  Google Scholar 

  50. Smith, C.R. and Lietman, P.S., Comparative clinical trials of aminoglycosides, in The Aminoglycosides. Microbiology, Clinical Use and Toxicology, Whelton, A. and Neu, H.C., Eds., Marcel Dekker, New York, 1982.

    Google Scholar 

  51. Trollfors, B., Quantitative studies on antibiotic nephrotoxicity, Scand. J. Infest. Dis., Suppl. 21, 1, 1980.

    Google Scholar 

  52. Murphy, P.A., Physiological changes in infected patients, in Oxford Textbook of Medicine, Vol. 1, Weatherall, D.J., Ledingham, J.G.G. and Warrell, D.A., Eds., Oxford University Press, Oxford, 1984, 519.

    Google Scholar 

  53. Young, L.S. Gram-negative sepsis in Principles and Practice of Infectious Diseases, 2nd Ed. Mandell, G.L., Douglas, R.G. and Bennett, J.E. Eds., John Wiley, New York, 452, 1985.

    Google Scholar 

  54. Morrison, D.C., Bacterial endotoxins and pathogenesis, Reviews of Infectious Diseases, Vol. 5, Suppl. 4, S733, 1983.

    Article  CAS  Google Scholar 

  55. Parker, M.M. and Parillo, J.E., Septic shock. Hemodynamics and pathogenesis, J. Am. Med. Assoc., 250, 3327, 1983.

    Article  Google Scholar 

  56. Editorial, Host responses in Gram-negative septicaemia, Lancet, 2, 69, 1982.

    Google Scholar 

  57. Wardle, N., Acute renal railure in the 1980s: the importance of septic shock and of endotoxaemia, Nephron, 30, 193, 1982.

    Article  PubMed  CAS  Google Scholar 

  58. Galpin, J.E., Shinaberger, J.H., Stanley, T.M., Blumenkantz, M.J., Bayer, A.S., Friedman, G.S., Montgomerie J.Z., Guze, L.B., Coburn, J.W. and Glas- sock, R.J. Acute interstitial nephritis due to methicillin, Am. J. Med., 65, 756, 1986.

    Article  Google Scholar 

  59. Wardle, E.N., Endotoxinaemia and the pathogenesis of acute renal failure, Q. J. Med., 44, 389, 1975.

    PubMed  CAS  Google Scholar 

  60. Werb, R. and Linton, A.L., Aetiology, diagnosis, treatment and prognosis of acute renal failure in an intensive care unit, Resuscitation, 7, 95, 1979.

    Article  PubMed  CAS  Google Scholar 

  61. Rasmussen, H.H. and Ibels, L.S., Acute renal failure: multivariate analysis of causes and risk factors, Am. J. Med., 73, 211, 1982.

    Article  PubMed  CAS  Google Scholar 

  62. Galpin, J.F., Chloramphenicol in typhoid fever, Br. Med. J., 1, 1047, 1949.

    Article  Google Scholar 

  63. Shenep, J.L. and Mogan, K.A., Kinetics of endotoxin release during antibiotic therapy for experimental Gram-negative bacterial sepsis, J. Infect. Dis., 150, 380, 1984.

    Article  PubMed  CAS  Google Scholar 

  64. Shenep, J.L., Barton, R.P. and Mogan, K.A., Role of antibiotic class in the rate of liberation of endotoxin during therapy for experimental Gram- negative bacterial sepsis, J. Infect. Dis., 151, 1012, 1985.

    Article  PubMed  CAS  Google Scholar 

  65. Kreger, B.E., Craven, D.E. and McCabe, W.R., Gram-negative bacteremia. IV. Re-evaluation of clinical features and treatment in 612 patients, Am. J. Med., 68, 344, 1980.

    Article  PubMed  CAS  Google Scholar 

  66. Schentag, J.J. Specificity in renal tubular damage for aminoglycoside nephrotoxicity in critically ill patients, J. Clin. Pharmacol., 23, 473, 1983.

    PubMed  CAS  Google Scholar 

  67. Smith, C.R., Ambinder, R., Lipsky, J.J., Petty, P.G., Israel, E., Levitt, R., Mellits, E.D., Rocco, L., Longstreth, J. and Lietman, P.S., Cefotaxime compared with nafcillin plus tobramycin for serious bacterial infections: a randomized, double-blind trial, Ann. Intern. Med., 101, 469, 1984.

    PubMed  CAS  Google Scholar 

  68. Beauchamp, D., Poirier, A. and Bergeron, M.G., Increased nephrotoxicity of gentamicin in pyelonephritic rats, Kidney Int., 28, 106, 1985.

    Article  PubMed  CAS  Google Scholar 

  69. Bergeron, M.G., Trottier, S., Lessard, C., Beauchamp, D. and Gagnon, P., Disturbed intrarenal distribution of gentamicin in experimental pyelonephritis due to Escherichia coli, J. Infect. Dis., 146, 436, 1982.

    Article  PubMed  CAS  Google Scholar 

  70. Trottier, S. and Bergeron, M.G., Intrarenal concentrations of ampicillin in acute pyelonephritis, Antimicrob. Agents Chemother., 19, 761, 1981.

    PubMed  CAS  Google Scholar 

  71. Tune, B.M. and Hsu, C.Y., Augmentation of antibiotic nephrotoxicity by endotoxemia in the rabbit, J. Pharmacol. Exp. Ther., 234, 425, 1985.

    PubMed  CAS  Google Scholar 

  72. Bergeron, M.G. and Bergeron, Y., Influence of endotoxin on the intrarenal distribution of gentamicin, netilmicin, tobramycin, amikacin and cephalothin, Antimicrob. Agents Chemother., 29, 7, 1986.

    PubMed  CAS  Google Scholar 

  73. Bergeron, M.G., Bergeron, Y. and Marois, Y., Autoradiography of tobramycin uptake by the proximal and distal tubules of normal and endotoxin-treated rats, Antimicrob. Agents Chemother., 29, 1005, 1986.

    CAS  Google Scholar 

  74. Halkin, H., Lidji, M. and Rubinstein, E., The influence of endotoxin-induced pyrexia on the pharmacokinetics of gentamicin in the rabbit, J. Pharmacol. Exp. Ther., 216, 415, 1981.

    PubMed  CAS  Google Scholar 

  75. Ambinder, R.F., Moore, R.D., Smith, C.R. and Mellits, E.D., Lack of evidence of interaction between tobramycin and shock in their effect on renal function, Antimicrob. Agents Chemother., 27, 217, 1985.

    PubMed  CAS  Google Scholar 

  76. Ziegler, E.J., McCutchan, J.A., Fierer, J., Glauser, M.P., Sadoff, J.C., Douglas, H. and Braude, A.I., Treatment of Gram-negative bacteremia and shock with human antiserum to a mutant Escherichia coli, N. Engl. J. Med., 20, 1227, 1982.

    Google Scholar 

  77. Baumgartner, J.D., McCutchan, J.A., Van Melle, G., Vogt, M., Luethy, R., Glauser, M.P., Ziegler, E.J., Klauber, M.R., Muehlen, E., Chiolero, R. and Geroulanos, S., Prevention of Gram-negative shock and death in surgical patients by antibody to endotoxin core glycolipid, Lancet, 59, 1985.

    Google Scholar 

  78. Gelman, M.L., Frazier, C.H. and Chandler, H.P., Acute renal failure after total hip replacement, J. Bone Joint Surg., 61A, 657, 1979.

    PubMed  CAS  Google Scholar 

  79. Moore, R.D., Smith, C.R., Lipsky, J.J., Mellits, E.P. and Lietman, P.S., Risk factors for nephrotoxicity in patients treated with aminoglycosides, Ann. Intern. Med., 100, 352, 1984.

    PubMed  CAS  Google Scholar 

  80. Luft, F.C., Cephalosporin and aminoglycoside interactions: clinical and toxicological implications, in The Aminoglycosides. Microbiology, Clinical Use and Toxicology, Whelton, A. and Neu, H.C., Eds., Marcel Dekker, New York, 1982, 387.

    Google Scholar 

  81. Luft, F.C., Cephalosporin and aminoglycoside interactions: clinical and toxicological implications, in The Aminoglycosides. Microbiology, Clinical Use and Toxicology, Whelton, A. and Neu, H.C., Eds., Marcel Dekker, New York, 1982, 387.

    Google Scholar 

  82. Craig, W.A., Gudmundsson, S. and Reich, R.M., Netilmicin sulfate: a comparative evaluation of antimicrobial activity, pharmacokinetics, adverse reactions and clinical efficacy, Pharmacotherapy, 3, 305, 1983.

    PubMed  CAS  Google Scholar 

  83. Kahlmeter, G. and Dahlager, J.I., Aminoglycoside toxicity - a review of clinical studies published between 1975 and 1982, J. Antimicrob. Chemother., 12, Suppl. A, 9, 1983.

    Google Scholar 

  84. Lerner, A.M., Cone, L.A., Jansen, W., Reyes, M.P., Blair, D.C., Wright, G.E. and Lorber, R.R., Randomised controlled trial of the comparative efficacy, auditory toxicity, and nephrotoxicity of tobramycin and netilmicin, Lancet, 1, 1123, 1983.

    Article  PubMed  CAS  Google Scholar 

  85. Lerner, S.A., Matz, G. J. and Schmitt, U., Prospective randomized, blinded assessment of nephro- and oto-toxicity in patients treated with gentamicin, Proceedings of Interscience Congress on Antimicrobial Agents and Chemotherapy, American Society for Microbiology, Washington, Abs. No. 488, 1984.

    Google Scholar 

  86. Schentag, J.S., Plant, M.E., Cerra, F.B., Wels, P.B., Walczak, P. and Buckley, R.J., Aminoglycoside nephrotoxicity in critically ill surgical patients, J. Surg. Res., 26, 270, 1979.

    Article  Google Scholar 

  87. Mondorf, A.W., Urinary enzymatic markers of renal damage, in The Aminoglycosides. Microbiology, Clinical Use and Toxicology, Whelton, A. and Neu, H.C., Eds., Marcel Dekker, New York, 1982, 283.

    Google Scholar 

  88. Wade, J.C., Smith, C.R., Petty, B.G., Lipsky, J.J., Conrad, G., Ellner, J. and Lietman, P.S., Cephalothin plus an aminoglycoside is more nephrotoxic than methicillin plus an aminoglycoside, Lancet, 604, 1978.

    Google Scholar 

  89. Smith, C.R., Lipsky, J.J., Laskin, O.L., Hellmann, D.B., Mellits, E.D., Longstreth, J. and Lietman, P.S., Double-blind comparison of the nephrotoxicity and auditory toxicity of gentamicin and tobramycin, N. Engl. J. Med., 1106, 1980.

    Google Scholar 

  90. Feinstein, A.V., An additional basic science for clinical medicine: II. The limitation of randomized trials, Ann. Intern. Med., 99, 544, 1983.

    PubMed  CAS  Google Scholar 

  91. Holloway, J.J., Smith, C.R., Moore, R.D., Feroli, E.R. and Lietman, P.S., Comparative cost effectiveness of gentamicin and tobramycin, Ann. Intern. Med., 101, 764, 1984.

    PubMed  CAS  Google Scholar 

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Authors
  1. P. G. Davey
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  2. E. S. Harpur
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Editor information

Editors and Affiliations

  1. The Robens Institute, University of Surrey, Guildford, Surrey, GU2 5XH, England

    P. H. Bach

  2. Biochemical Toxicology Section, Imperial Chemical Industries plc, Alderley Park, Macclesfield, Cheshire, SKI0 4TJ, England

    E. A. Lock

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Davey, P.G., Harpur, E.S. (1987). Antibiotics: The Experimental and Clinical Situation. In: Bach, P.H., Lock, E.A. (eds) Nephrotoxicity in the experimental and clinical situation. Developments in Nephrology, vol 19-20. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-3371-2_7

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  • DOI: https://doi.org/10.1007/978-94-009-3371-2_7

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  • Online ISBN: 978-94-009-3371-2

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