Acute renal failure associated with combined gentamicin and cephalothin therapy

Three patients with normal renal function developed acute renal failure between the ninth and twenty-seventh days of combined gentamicin and cephalothin therapy. The dose of gentamicin (4-6 mg/kg/day) was in the normal range, but that of cephalothin (180 mg/kg/day) was abnormally high. The nephropathy was of the tubular-interstitial type and the clinical picture similar to that seen in acute drug-induced nephropathies. Frusemide was given only after the onset of renal failure. In these three patients the high intravenous doses of cephalothin combined with gentamicin were probably nephrotoxic.