PubMed · 897716
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H D Riley. 1977. "Gentamycin"--no!. https://pubmed.ncbi.nlm.nih.gov/897716/
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Carrier systems for local gentamicin (GS) treatment based on collagen sponges and polymethylmethacrylate beads show pharmacokinetic disadvantages in their GS-release profiles. Therefore, poly(lactic-co-glycolic acid) (PLGA) microparticles were devised. None of the five poly(alpha-hydroxy acid)s tested resulted in the desired antibiotic release over approximately one week. However, preparing microparticles from a 50/50 blend of Resomer RG 502H, an uncapped variety, and Resomer RG 503, an endcapped polymer, yielded the targeted liberation profile. The mechanism of GS release was investigated by analyzing water uptake and polymer molecular weight. Release of GS from RG 502H particles occurred instantaneously and coincided with substantial water penetration. Particles prepared from RG 503 started out at a higher molecular weight and since the endcapped polymer takes up less water, the decrease in molecular weight was delayed. The threshold of collapse was reached after two weeks, which coincided with water penetration and GS release. For the 50/50 RG 502H/RG 503 blend, this process was delayed for two to three days. Hydrolysis occurred at the same rate as for RG 502H due to the high water content as a consequence of the uncapped polymer fraction and renders GS release over one week with release limited to 30% in the first two days due to the endcapped polymer fraction of higher molecular weight. Thus, the mixture of endcapped and uncapped Resome exhibits a new quality for adjusting drug release from poly(alpha-hydroxy acid)s.
Clinical efficacy of netilmicin was evaluated at 22 newborns (body weight from 1000 to 3600 g, delivery on pregnancy period from 28 to 41 weeks) with pneumonia caused by artificial pulmonary ventilation. Pneumonia was moderate at 13 patients and severe at 9 patients. Microorganisms isolated from tracheobronchial aspirates were mainly (in 19 cases of 22) susceptible to netilmicin. The usage of netilmicin in combination with cephalosporins was effective at the main part of the newborns and resulted with the full recovery of 11 newborns (all the patients with moderate pneumonia), in 9 cases improvement was registered (including 7 newborns with severe pneumonia). Newborns with severe pneumonia had a slow pathogens elimination.
OBJECTIVE: To review the literature relating to intratympanic gentamicin injection therapy for Meniere's disease to detect consistencies and differences that might suggest optimal technique. DESIGN: Retrospective literature review. METHODS: Eighteen papers from the literature regarding clinical experience with intratympanic gentamicin injections for treatment of Meniere's disease were reviewed and tabulated. RESULTS: All papers reported high success rates in treating episodic vertigo of Meniere's disease, but technique, dose, duration, and treatment philosophy varied considerably. Hearing loss was typically reported in about 30% of patients. CONCLUSION: No single technique of gentamicin injection has a significant medical advantage over the others. Until controlled studies indicate otherwise, nonmedical needs such as convenience and safety may be considered when choosing a technique.