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At least 199 records · Page 11Linked to original sources
PubMed1990

[Long-term effect of the administration of repeated single doses of netilmicin in urinary tract infections].

In 26 patients with different clinical forms of infections of the urinary pathways a 300 mg single dose of netilmicin was administered by the i.m. route and the bacteriological urinary finding was checked for as long as 10 weeks after administration of netilmicin. During this period the urine was bacteriologically negative in 42% of the subjects. In 8 subjects with relapses of the infection a second dose of 300 mg netilmicin was administered and the urine was bacteriologically negative for 10 weeks in four of the patients. On the whole it proved possible to eliminate the urinary infection for 42-112 days in 17 subjects (65%), even in so-called complicated infections. It may be stated that single dose treatment with netilmicin used once or repeatedly leads to prolonged elimination of the infection without affecting the sensitivity of the organisms, without side-effects and with a substantial reduction of the cost of treatment.

Adult↗
PubMedDate not supplied

[Endobronchial administration of netilmicin in patients with bronchopulmonary infections seen in the neurosurgical intensive care unit].

The Authors report the results obtained in the treatment of bronchopulmonary infections in patients hospitalized in the Neurosurgical Intensive Care Unit. Netilmicin was administered by systemic and endobronchial routes. The cleaning of the bronchial tree was always performed. Twenty-six patients (16 males and 10 females) were enrolled and assigned to one of the following groups. Group A: 16 patients with confirmed pneumonia; Group B: 10 patients without bronchopulmonary infections, as controls for serum pharmacokinetic study. In the majority of the cases pneumonia was caused by Staphylococcus aureus and Pseudomonas aeruginosa. The results obtained were positive: pneumonia resolution was observed in 10 patients (67%), improvement in 4 (27%) and failure in one case (6%). A pharmacokinetic study has confirmed bacteriologically active serum levels of netilmicin and also the availability of netilmicin within the bronchial secretions. Endobronchial plus systemic netilmicin administration was active and well tolerated in these critical patients.

Bronchi↗
PubMed1989

[Netilmicin in the treatment of infections of the lower urinary tract].

The authors treated 30 patients (11 females and 19 males) with cystitis or cystopyelitis. Patients were randomly assigned to one of the following treatments: a) netilmicin 200 mg daily, b) netilmicin 200 mg + ampicillin 1 g daily. Clinical and bacteriologic results were positive in all cases with resolution of clinical signs of infection and negative cultures at the end of treatment. Netilmicin alone yielded the same results as its combination with ampicillin. The safety, monitored also with netilmicin serum levels, was always good.

Aged↗
PubMed1986

Vestibular toxicity following netilmicin therapy in the neonatal period.

Thirty-seven children treated with netilmicin during the neonatal period were seen at follow-up at the age of 2-4 years to investigate for possible vestibular damage caused by netilmicin therapy. No definite vestibular damage could be found in these 37 patients, including three patients in whom greatly elevated serum concentrations of netilmicin had been measured. The present study confirms previous findings in adults showing a low ototoxicity of netilmicin.

Female↗
PubMed1987

Aminoglycoside redistribution phenomenon after hemodialysis: netilmicin and tobramycin.

The serum concentration time profile of netilmicin and tobramycin before, during, and after hemodialysis was assessed in 5 noninfected adult chronic hemodialysis patients. The pharmacokinetic profile was biexponential for both agents in the pre-hemodialysis period. The total body clearance of netilmicin was significantly greater than that of tobramycin (5.32 +/- 0.75 ml/min vs 3.66 +/- 1.00 ml/min; p less than 0.05). The hemodialysis clearances of netilmicin and tobramycin were similar (60.8 +/- 16.6 ml/min and 54.7 +/- 18.8 ml/min, respectively). Netilmicin and tobramycin serum concentrations increased significantly 10 minutes after cessation of hemodialysis and maximally rebounded to 38.3 +/- 16.2% and 18.3 +/- 3.0% at 1.7 +/- 0.3 hours and 1.9 +/- 0.7 hours, respectively. This phenomenon may be a primary contributor to the marked variability observed in the clinical pharmacokinetics of these agents in hemodialysis patients. These data suggest that clinical serum concentrations should not be drawn until two hours after hemodialysis.

Adult↗
PubMed1987

Renal handling of netilmicin in the rat with streptozotocin-induced diabetes mellitus.

We examined the hypothesis that the reduced accumulation of aminoglycoside in renal cortex of rats with streptozotocin-induced diabetes mellitus (DM) is secondary to lower rates of tubular transport of drug compared with non-DM rats. Using whole kidney clearance techniques we found that the fractional excretion of [3H]netilmicin in DM rats rose from an initial value of 92.4 +/- 1.3% to 101 +/- 4.5% (N = 10) after eight 20-min periods. These values were not significantly different from those of non-DM rats (96.4 +/- 1.8 and 106.7 +/- 1.4%, respectively, N = 7). The plasma concentration of drug was similar in the two groups whereas inulin clearance and the filtered load of drug were higher in DM rats. In both groups microinjection experiments revealed the presence of an absorptive flux of [3H]netilmicin along the proximal tubule and loop of Henle, but no absorptive flux was detected along the distal nephron. In free-flow micropuncture experiments in DM rats a net secretory flux of netilmicin was detected in the early proximal tubule and a net absorptive flux was detected along the loop of Henle, presumably the pars recta. No net flux occurred along the distal tubule. These findings are similar to those previously reported by us for non-DM rats. At the end of the clearance experiments the concentration of netilmicin in renal cortex of DM rats (56 +/- 5 micrograms/g wet wt.) was significantly less (P less than .01) than that in the renal cortex of non-DM rats (122 +/- 6 micrograms/g wet wt).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

Compatibility of clindamycin phosphate with cefotaxime sodium or netilmicin sulfate in small-volume admixtures.

The stability and compatibility of clindamycin phosphate plus either cefotaxime sodium or netilmicin sulfate in small-volume intravenous admixtures were studied. Admixtures containing each drug alone and two-drug admixtures of clindamycin phosphate plus cefotaxime sodium or netilmicin sulfate were prepared in 100 mL of 5% dextrose injection and 0.9% sodium chloride injection in both glass bottles and polyvinyl chloride (PVC) bags. Final concentrations of clindamycin, cefotaxime, and netilmicin were 9, 20, and 3 mg/mL, respectively. All solutions were prepared in duplicate and stored at room temperature (24 +/- 2 degrees C). Samples were visually inspected, tested for pH, and assayed for antibiotic concentration using stability-indicating assays at 0, 1, 4, 8, 16, and 24 hours for admixtures in glass bottles and at 0, 8, and 24 hours for admixtures in PVC bags. No substantial changes in color, clarity, pH, or drug concentration were observed in any of the solutions. Clindamycin phosphate is compatible with cefotaxime sodium or netilmicin sulfate in 5% dextrose and 0.9% sodium chloride injections in glass bottles or PVC bags for 24 hours.

Cefotaxime↗
PubMed1985

Long-term intermittent netilmicin therapy of chronic pyelonephritis: a pharmacokinetic and clinical study.

A trial was conducted with long-term intermittent netilmicin therapy in six patients suffering from chronic pyelonephritis. Netilmicin was given in full dose for a period of 3-10 days (2-6 mg/kg/day), followed by 2 mg/kg doses once or twice weekly for 3-6 months. Individual doses were determined by computer based on the age, sex, lean body weight and serum creatinine concentrations of the patients. During the full-dose period of treatment netilmicin concentrations in serum were between 2 and 16 mg/l in serum and between 50 and 200 mg/l in urine. During intermittent treatment serum levels remained below 2 mg/l (except for 8-12 hours after dosing); in the urine concentrations were permanently in therapeutic ranges (150-4 mg/l). Renal tissue levels were simulated. Six to 12 months after long-term netilmicin treatment all patients are abacteriuric and free from symptoms. No auditory or renal toxic effects occurred.

Adult↗
PubMed1984

Comparison of single dose netilmicin with a five-day course of co-trimoxazole for uncomplicated urinary tract infections.

Women with uncomplicated urinary tract infections were randomly allocated to either a single 150 mg intramuscular dose of netilmicin or a standard five-day course of oral co-trimoxazole. Twenty-one of 22 were cured with netilmicin and all 20 with co-trimoxazole. No patient treated with netilmicin developed any side effects or obvious toxicity. Following co-trimoxazole one woman developed a severe skin rash and another nausea. Netilmicin is another drug which is highly effective when used in a single dose regimen for the treatment of uncomplicated urinary tract infections. There are many advantages of this approach to the management of a common clinical problem.

Administration, Oral↗
PubMed1980

Netilmicin in the treatment of severe or complicated urinary tract infections.

Netilmicin is a new aminoglycoside antibiotic with pharmacological similarities to gentamicin, tobramycin and sisomicin. Fourteen of 15 patients with a severe or complicated urinary tract infection were cured by treatment with a seven day course of netilmicin. In one patient the infecting organism was not eradicated. No significant side effects were noted and no ototoxicity was detected. Four patients had a significant, but reversible, deterioration in renal function as defined by an increase in the plasma creatinine of 0.03 mmol/l or greater. Work in experimental animals has shown netilmicin to be significantly less ototoxic and nephrotoxic than other clinically available aminoglycosides. If this finding is confirmed in large-scale comparative trials in man, netilmicin should prove a most useful and effective new antibiotic for the treatment of severe gram-negative sepsis.

Adult↗
PubMed1980

Netilmicin therapy of patients with septicaemia and other severe infections.

25 patients were treated with netilmicin because of suspected or verified septicaemia or other severe infections. Netilmicin was administered intramuscularly in a dose of 2 mg/kg body weight every 8 hours. For patients with elevated plasma creatinine the dosage was reduced according to the degree of elevation. Average length of treatment was 7 days (3-12 days). In 22 patients all symptoms and signs of infection disappeared. In one patient antibiotic treatment had to be changed and in two patients abscesses had to be surgically drained. Kidney function was monitored during and after treatment by plasma creatinine measurements and 51Cr-EDTA clearance. Netilmicin was discontinued in 4 patients because of an increase in plasma creatinine but little or no drug related nephrotoxicity was observed. Audio-vestibular function was monitored during and after treatment. Netilmicin was discontinued in one patient because of slight subjective loss of hearing. Subsequent audio-vestibular examination was normal.

Adult↗
PubMed1980

High dose netilmicin therapy of severe or chronic infections.

Sixteen patients with chronic or recurrent urinary tract infections, 14 with septicaemia, 2 with salmonellosis, 2 with pneumonia and 1 with acute mastitis were treated with 200 mg (2.2-3.6 mg/kg) netilmicin intramuscularly every 8 hours for 7-10 days (mean 8.8 days). 28 patients were cured, 5 showed marked improvement and 2 patients with septicaemia and severe underlying diseases failed to respond to treatment. The bacterial isolates were inhibited by 4.0 mg netilmicin/l or less. Antibiotic serum level determinations were performed in 32 patients. Mean serum concentrations of netilmicin 1 and 8 hours after injection were 12.6 and 2.0 mg/l respectively in 27 patients with normal serum creatinine levels. In 5 patients with elevated serum creatinine, mean peak and trough values were 21.5 and 5.8 mg/l, respectively. Mean netilmicin concentrations in serum and skin blister fluid obtained from 4 patients were equal 2-3 hours after injection, indicating appropriate tissue penetration. Nephrotoxicity occurred in 2 patients. Ototoxicity was not demonstrated. Netilmicin appears to be an effective and safe drug in the treatment of a variety of bacterial infections.

Adult↗
PubMed1980

Prospective evaluation of vestibular and auditory function in 76 patients treated with netilmicin.

Seventy-six patients were included in a prospective study in order to assess the ototoxicity of netilmicin. Netilmicin. Netilmicin was administered intramuscularly with a dosage of 1.5 mg/kg body weight 2 or 3 times daily. The dosage was modified in cases with even slight renal insufficiency. Vestibular and auditory function was examined by electronystagmography (ENG) and audiometry before and during therapy, 1 week and 2-3 months after completion of therapy. Drug-related VIIIth nerve toxicity--vestibular dysfunction--was suspected in one case. However, this dysfunction was subclinical and reversible. The importance of pretreatment evaluation was obvious as an ototoxic damage might have been suspected in 14 patients if the pretreatment examination of vestibular and auditory function had not been performed. Clinical ototoxicity of netilmicin seems to be low when careful attention is paid to the renal function and the serum concentrations of the drug.

Adolescent↗
PubMed1981

Preclinical toxicologic studies of netilmicin.

1-N-Ethylsisomicin (netilmicin), a semisynthetic aminoglycoside antibiotic, was given parenterally to mice, rats, guinea pigs, rabbits, and dogs for toxicological evaluation. Acute signs of toxicity were consistent with neuromuscular blockade. Results of teratological studies in rats and rabbits were negative; the only effect observed was wavy ribs, a minor developmental variation, in rats. No effects were found on fertility, reproduction, or development of offspring. Single daily doses of 60 mg/kg s.c. for 10 weeks in young rats and 30 days in young dogs were non-toxic. No indication of toxicity was found in rats and dogs given single daily doses of 7.5 mg/kg i.v. for 2 weeks. Daily i.m. doses caused signs of neuromuscular blockade in rats after 2 weeks at 100 mg/kg and after 1 month at 50 mg/kg, and in dogs after 2 months at 75 mg/kg; dose levels of 150 mg/kg did not cause renal failure. No ocular changes or impairment of vestibular or auditory function were evident at any dose studied. Comparison with tobramycin, gentamicin, and kanamycin at s.c. doses of 50 or 150 mg/kg per day for 4 weeks showed netilmicin to be less nephrotoxic in rats than tobramycin or gentamicin and only slightly more nephrotoxic than kanamycin. Only mild changes were seen microscopically in kidneys of dogs given netilmicin at daily doses of 75 mg/kg i.m. for 3 months. The renal effects of netilmicin given at high multiples of the human therapeutic dose were one-half to one-third less that those of gentamicin and were not severe at any dosage.

Abnormalities, Drug-Induced↗
PubMed1980

Antimicrobial activity of netilmicin in comparison with gentamicin, sisomicin, tobramycin, and amikacin and their resistance patterns.

The antimicrobial activity of netilmicin, gentamicin, sisomicin, tobramycin and amikacin was determined by means of the microdilution test. 1000 fresh isolates of strains of Staphylococcus aureus, Pseudomonas aeruginosa and 7 species of the Enterobacteriaceae were tested. The activities were compared and cross-resistances were analyzed which appeared among the various drugs. Against amikacin, only 0.5% of all strains (3 P. aeruginosa, 1 S. aureus, 1 P. mirabilis) were resistant. Of the other drugs, netilmicin was the most active drug against S. aureus, Klebsiella spp., Enterobacter spp. and Escherichia coli. Against E. coli, too, sisomicin showed its best activity, and further against Citrobacter spp., Proteus spp. and P. aeruginosa. A total of 12% of all pathogens was gentamicin-resistant. With one exception, these pathogens showed cross-resistance to at least one of the other drugs. In 39% of the cases a cross-resistance between gentamicin and tobramycin was noted, in 26% a gentamicin-tobramycin-sisomicin cross-resistance, in 17% gentamicin-tobramycin-sisomicin-netilmicin cross-resistance, in 11% a gentamicin-sisomicin-netilmicin cross-resistance. A complete cross-resistance was observed between gentamicin and sisomicin with S. aureus, Serratia spp. and Proteus mirabilis, between gentamicin and tobramycin with E. coli, Citrobacter spp. and Enterobacter spp.

Amikacin↗
PubMed1980

Netilmicin use in pediatric patients.

40 newborn infants and children were treated with netilmicin. With a 2-mg/kg dose, the average peak serum concentration was 4.4 microgram/ml. Serum concentrations resulting from the first dose were markedly lower than subsequent doses and therapeutically inadequate. Significant drug accumulation did not occur: peak and trough concentrations on days 2 and 7 were the same in patients with normal renal function. The half-life of netilmicin in infants less than 1 week old was 3.8 h in infants older than 1 week. Infants less than 7 days old require a prolonged dose interval (12 h) to adequately clear the administered dose. Recovery of netilmicin in urine ranged from 50 to 100% and correlated with age and duration of treatment. Elimination of netilmicin was prolonged in newborn infants with renal failure and requires dosage adjustment. Transient change in creatinine clearance occurred in 2 patients (4.6%) and ototoxicity was observed on 2 other patients.

Adolescent↗
PubMed1994

[Pharmacokinetics of netilmicin in the first use in newborn infants with gestational ages greater than 34 weeks].

BACKGROUND: Neonatal bacterial infections are potentially lethal. The infant must be started on an antibiotic regimen to cover the organisms most frequently implicated. Since the introduction of gentamicin therapy for neonatal infections, attention has focused on aminoglycoside pharmacokinetics in these very young patients. PATIENTS AND METHODS: The pharmacokinetics parameters of netilmicin during its first administration were analysed in 22 newborn infants with a gestational age over 34 weeks, aged 1 to 3 days, in whom a maternofetal infection was suspected. Netilmicin was given intravenously at a dose of 6 mg/kg/day in two daily injections for 35 minutes. Blood concentrations of netilmicin were measured from samples taken 5, 15, 30, 60 minutes and 2 1/2, 5 1/5 and 11 1/2 hours after injection. The patients were also given cefotaxime plus ampicillin. RESULTS: The kinetics were bicompartimental: prematurity, proven infections and other perinatal factors influenced the pharmacologic parameters and it was not possible to define a predictive formula for antibiotic administration. CONCLUSION: The blood levels of netilmicin must be monitored even in infants who were not born prematurely. Because of the large distribution volume and the long half-life, we propose a dose of 6-7.5 mg/kg given once daily.

Bacterial Infections↗
PubMed1994

[Morphological change in the retina after injection of calcium and netilmicin sulfate in the rabbit vitreous body].

We reported previously selective damage of the outer segment of the photoreceptors and retinal pigment epithelium after intravitreal injection of netilmicin sulfate in the rabbit. The cellular damage was thought due to active damage of phospholipase C enzyme, preventing it from performing phospholipid inositol metabolism, and to the presence of calcium. Therefore we investigated the retinal damage following after intravitreal injection of calcium and netilmicin sulfate in the rabbit. Morphologically, the retina did not show any structural change after intravitreal injection of CaCl2 at any concentration. After an intravitreal injection of netilmicin sulfate mixed with CaCl2, the damage in the photoreceptor outer segment was reduced at a concentration of 200 micrograms/0.1 ml and in the retinal pigment epithelium at a concentration of 1,000 micrograms/0.1 ml. This showed that retinal damage due to netilmicin sulfate can be reduced by the addition of calcium.

Animals↗