THE ABSORPTION, EXCRETION, AND DISTRIBUTION OF PENICILLIN 1

Abstract

In 1929, Fleming (1) described an active anti-bacterial substance, penicillin, obtained from the mold, Penicillium notatum. This substance has been shown to exhibit a marked antibacterial ef-fect both in titro (1, 2) and in the experimental animal (2). In man, the observations on the ef-ficacy of penicillin as a therapeutic agent have been limited to those of Florey and his co-workers (3). As a part of our investigation of the therapeu-tic effectiveness of penicillin in various infections, this study was undertaken to determine its absorp-tion, excretion, and distribution when adminis-tered by various routes. MATERIALS AND METHODS The subjects included normal volunteers and ward pa-tients. The latter group were for the most part suffering from localized infections. Unless otherwise indicated, the urine and the blood non-protein nitrogen were normal in each subject. The majority of the studies were made in the fasting state; however, after the first 4 hours of ob-servation fluids were not limited. Penicillin 2 in the form of the sodium salt was dissolved in either distilled water or 0.85 per cent sodium chloride solution and passed through a Seitz filter to effect steri-lization. The final concentration of all solutions of peni-cillin was 1,000 Florey units per cubic centimeter except that administered subcutaneously, which contained 200 Florey units per cubic centimeter of 0.85 per cent sodium chloride. The various solutions of penicillin were stored at 50 C. until time of use. Penicillin was administered by the oral, intraduodenal, rectal, intravenous, subcutaneous, intramuscular, intra-pleural, intra-articular, and intrabursal routes. The oral and rectal doses were administered in 200 cc. of tap water. Prior to rectal administration the subject was given a soap-and-water enema. Intraduodenal administra-tion was effected through a Miller-Abbott tube, the posi-tion being checked by fluoroscopic examination. Intra-articular and intrabursal injections were made after aspi-1 Supported by a grant from the Johnson Research Foundation, New Brunswick, New Jersey. 2 The penicillin used in this study was supplied through