THE EVALUATION OF AN EFFECTIVE DOSAGE OF CARONAMIDE (4-CARBOXYPHENYLMETHANESULFONANILIDE) FOR THE SUPPRESSION OF TUBULAR EXCRETION OF PENICILLIN IN CHILDREN 1234

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Abstract
A comparison of the excretion rates of penicillin given intramusc. alone and with varying oral doses of caronamide was used to detn. the dose of caronamide effecting complete suppression of tubular excretion. An estimated 71-100%, with an avg. of 91%, suppression was achieved in 20 trials with 0.55-0.70 g./kg./24hrs. of caronamide in children between 2 and 9 yrs. In 23 trials at doses within this range, such suppression of tubular function failed to occur in 3. This was apparently due to a failure of absorption of caronamide from the gastro-intestinal tract. Suppression of tubular excretion led to the maintenance of effective blood levels of penicillin for as long as 6-8 hrs. after the admn. of a dose of approx. 10,000 U./kg. Toxic symptoms of anorexia, nausea, and vomiting were encountered in 4 patients only with doses higher than those finally recommended. One mild drug rash was encountered. Two other children, not in the series, were observed to have a severe sensitivity reaction resembling that encountered with the sulfonamides. The main clinical use of caronamide will probably be for the treatment of patients infected with relatively penicillin-resistant organisms.