414 ANNUAL REPORT SMITHSONIAN INSTITUTION, 1952 



may exceed 6 or 8 fig. per ml. From the circulation, aureomycin 

 readily passes into the peritoneal fluid, spinal fluid, bile, urine, and 

 milk. It passes into the fetal circulation through the placenta and 

 has been found in the liver, kidney, lung, and spleen. Aureomycin 

 probably passes the blood-brain barrier in therapeutic amounts and 

 the presence or absence of inflammation is not a controlling factor 

 as it is in the case of penicillin and streptomycin. 



The concentration of aureomycin found in the urine following 

 oral administration of this drug in either single or multiple doses 

 is relatively high. Peak concentrations of from 50 to 250 /xg. per ml. 

 of urine are obtained following single doses of from 0.5 to 2.0 grams. 

 For the most part these peak concentrations may be maintained by 

 similar doses given every six hours. The successful use of this drug 

 in certain types of urinary-tract infections, particularly those of the 

 bladder, is in large part due to the relatively high excretion rate of 

 this drug. 



CHLORAMPHENICOL 



Chloramphenicol was the first of the broad-spectrum antibiotics to 

 be reported in the medical literature. The generic term "chlor- 

 amphenicol" was derived from the now known structure of this drug 

 which was first called "Chloromycetin." The latter name, which in- 

 cidentally is also descriptive of the drug, is the trade-mark name. 

 Chloramphenicol is unique among the antibiotics. It is the first and 

 only antibiotic ever synthesized on a commercial basis. The produc- 

 tion of this drug, which today is measured in tons and produced 

 largely by synthesis, was an extraordinary acomplishment. 



Chloramphenicol is a drug of remarkably low toxicity. A review 

 of its clinical history indicates that the great majority of investigators 

 who have used this drug report "no untoward reactions." The nitro- 

 benzene nucleus might suggest toxicity for man, yet in a relatively 

 large number of patients on high dosages, no evidence of intolerance 

 or toxicity has been observed.* 



Although side reactions such as nausea, headache, skin eruptions, 

 and enteritic symptoms are rare following the use of therapeutic doses 

 of chloramphenicol, occasional untoward reactions, minor in char- 

 acter, have been recorded. In one case there was an altered sense of 

 taste; food lost its savor and smoking was not pleasant. A second 

 side effect was the appearance of a sensitivity response which occurred 

 on the sixth day of treatment. At this time the patient felt some- 

 what dizzy, his face became flushed, and numerous red macular lesions 

 appeared over his face. The pulse and respiratory rates were ac- 



4 At the present time (July 1952) evidence from both published and unpublished sources 

 Indicate that chloramphenicol has caused blood dyscrasias in certain Individuals. While 

 about half of the accumulated cases have been diagnosed as aplastic anemia, the over-all 

 Incidence of these blood dyscrasias appears to be quite low. 



