Abstract
Two different isoxazolylpenicillins (cloxacillin and dicloxacillin) were compared regarding impairment of renal function after total hip arthroplasty. 85 patients received dicloxacillin and 93 patients received cloxacillin as antibiotic prophylaxis. A total dose of 6 grams was given during a 36-hour period in doses of 1 gram pre-, per- and postoperatively. Creatinine in serum and beta 2-microglobulin in serum and urine were determined preoperatively and 2, 4, and 10 days after the operation. The dicloxacillin-treated patients had an increase in creatinine and beta 2-microglobulin in serum that was not seen in the cloxacillin group. The increase indicates a transient injury in the process of glomerular filtration. Although the increase was temporary and subclinical, a dose reduction is nevertheless recommended for older patients.
Publication types
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Comparative Study
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Research Support, Non-U.S. Gov't
MeSH terms
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Age Factors
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Aged
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Aged, 80 and over
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Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
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Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
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Aspirin / administration & dosage
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Aspirin / therapeutic use
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Cloxacillin / administration & dosage
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Cloxacillin / adverse effects*
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Creatinine / blood
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Dicloxacillin / administration & dosage
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Dicloxacillin / adverse effects*
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Dose-Response Relationship, Drug
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Drug Therapy, Combination
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Female
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Glomerular Filtration Rate / drug effects*
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Hip Prosthesis*
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Hospitals, University
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Humans
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Infusions, Intravenous
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Male
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Postoperative Complications / epidemiology
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Postoperative Complications / etiology
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Premedication / adverse effects*
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Premedication / methods
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Prospective Studies
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Sweden / epidemiology
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beta 2-Microglobulin / analysis
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beta 2-Microglobulin / urine
Substances
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Anti-Inflammatory Agents, Non-Steroidal
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beta 2-Microglobulin
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Creatinine
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Dicloxacillin
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Cloxacillin
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Aspirin