Severe methicillin-induced renal failure treated with hemodialysis

We describe the clinical course of a patient who developed anuria following prophylactic methicillin administration. To the best of our knowledge, this is the first report of prolonged anuria following administration of this drug. The patient's nephropathy developed as a result of routine perioperative antibiotic prophylaxis for cardiac surgery and resulted in a two-week period of complete anuria. Following discontinuation of methicillin the patient was supported throughout this period by intermittent hemodialysis and eventually had an excellent recovery of renal function without concurrent use of corticosteroids. Thus methicillin may occasionally cause severe and prolonged anuric renal failure, but maximal supportive measures, including dialysis when necessary, should nonetheless be used, since the renal failure is reversible once the antibiotic is discontinued.