BACITRACIN NEPHROPATHY

Abstract

Bacitracin, a polypeptide produced by Bacillus subtilis, was discovered in 1945 by Johnson, Anker, and Meleney.¹ The early enthusiasm that followed the demonstration of its potent antibacterial action was soon dampened by reports of the nephrotoxic action of this and related polypeptide antibiotics² both in experimental animals and in man.³ In nearly every reported case, clinicians observed transient urinary abnormalities when bacitracin therapy was extended over a few days. The resulting proteinuria, cylindruria, azotemia, and occasional oliguria usually were self-limited, but at times necessitated termination of therapy. A review of the literature fails to reveal any fatality attributed to this antibiotic, so that the description of the renal lesion in a human being is lacking. The following case report is that of a patient with acute bacterial endocarditis. Renal failure unrelated to her primary disease developed in this woman after the institution of bacitracin therapy. REPORT OF