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PubMed1983

Comparative clinical efficacy and safety of netilmicin and tobramycin in children with serious gram-negative infections.

Thirty children with serious gram-negative infections were treated with either netilmicin, 2 mg/kg, or tobramycin, 1 mg/kg, every eight hours for a minimum of 72 hours. Because of the administration of different doses, a "blind" investigator evaluated treatment response while another investigator adjusted the doses on the basis of each patient's drug serum levels and bacteriological response. Comparisons between the two study groups showed both treatments to be equally effective. All 15 patients treated with netilmicin and 14 of the 15 patients treated with tobramycin experienced complete resolution of clinical signs and symptoms and elimination of pathogens. One child in the tobramycin group was considered a treatment failure because of a persistent urinary tract infection. There were no adverse effects attributable to either drug.

Anti-Bacterial Agents↗
PubMed1984

In vitro susceptibilities of mucoid Pseudomonas aeruginosa isolates from cystic fibrosis patients against azthreonam, netilmicin and piperacillin.

Minimum bacteriostatic (MIC) and bactericidal (MBC) levels were done on 37 clinical isolates of mucoid Pseudomonas aeruginosa from cystic fibrosis patients against azthreonam, netilmicin and piperacillin. Results show that piperacillin had the greatest bacteriostatic activity; however there was more likely to be a significant disparity between MIC and MBC with this drug. Netilmicin was less active than piperacillin, but there was less difference between MICs and MBCs. Azthreonam was the least active compound tested.

Anti-Bacterial Agents↗
PubMed1981

Effect of concentration and time upon inactivation of tobramycin, gentamicin, netilmicin and amikacin by azlocillin, carbenicillin, mecillinam, mezlocillin and piperacillin.

Carbenicillin and ticarcillin have been shown to inactivate aminoglycoside antibiotics. This study evaluated the effect of time upon in vitro interaction between mixtures of four aminoglycoside antibiotics at two concentrations with azlocillin, mecillinam, mezlocillin, piperacillin and carbenicillin at three concentrations. By linear regression analysis, the inactivation of each aminoglycoside antibiotic was shown to be directly proportional to the concentration of the semisynthetic penicillin. Aminoglycoside inactivation was greater after 72 hr of incubation with the penicillins than after 24 hr of incubation. Inactivation by each semisynthetic penicillin was greater for tobramycin and gentamicin than for netilmicin and amikacin, especially at higher concentrations of the penicillins. At concentrations of 500 microgram/ml, significantly less inactivation of amikacin occurred when compared to netilmicin. There was little difference in inactivation of a specific aminoglycoside by any of the semisynthetic penicillin antibiotics. No significant change in aminoglycoside activity occurred when the aminoglycosides were stored with the semisynthetic penicillin derivatives at -70 degrees C for 30 days. Conclusions from this study are: 1) serum specimens containing aminoglycoside-penicillin combinations should be tested immediately or frozen before antibiotic assay and 2) aminoglycoside inactivation by the newer semisynthetic penicillins may be important in patients with renal failure who are receiving these antimicrobial agents.

Amdinocillin↗
PubMed1984

Netilmicin sulfate prophylaxis in the surgical treatment of renal stones.

The role of short course (three doses) and single dose peroperative antibiotic (netilmicin sulfate) prophylaxis were studied in 42 patients undergoing removal of renal calculi. In an untreated group, the urine sample taken preoperatively was infected in 37.5 per cent, but the removed stone demonstrated significant bacterial growth in 67 per cent, with a wound complication rate of 25 per cent. Use of antibiotic prophylaxis reduced the wound complication rate to 5 per cent. Satisfactory serum levels of the antibiotic were achieved during the operative period, with an acceptable rate of clearance of netilmicin sulfate from the blood stream.

Creatinine↗
PubMed1982

A survey of prospective, controlled clinical trials of gentamicin, tobramycin, amikacin, and netilmicin.

Data from 24 prospective, controlled clinical studies of the aminoglycosides gentamicin, tobramycin, amikacin, and netilmicin are reviewed. According to these findings, netilmicin is the safest and most effective of the four types (P less than 0.01, both comparisons), and gentamicin is more effective than tobramycin (P less than 0.05) and less ototoxic than amikacin (P less than 0.05).

Amikacin↗
PubMed1980

Compiled data on aminoglycoside, foremost netilmicin susceptibility of bacterial strains.

The MIC-values of 73 bacterial strains isolated in Malmö from patients treated with netilmicin have been determined by the agar dilution method for five aminoglycosides: amikacin, gentamicin, netilmicin, sisomicin and tobramycin. The results are compared with those obtained with the disc diffusion method in another Swedish investigation, comprising 202 strains and with results obtained in other places. Among the strains isolated in the two Swedish investigations, Escherichia coli strains were most prevalent, 28 and 77 respectively, and in this group no important differences could be found except for sisomicin. The importance of the inoculum size was investigated in a separate study on 24 strains of the Malmö material. These strains had also been tested one year earlier, using another size of the inoculum. The comparison showed that an inoculum less than 10(4) colony forming units resulted in lower MIC-values.

Acinetobacter↗
PubMed1982

[Clinical study on netilmicin in the treatment of complicated urinary tract infection caused by Pseudomonas aeruginosa].

Netilmicin was intramuscularly injected at a daily dose of 200 mg, divided twice, for 5 to 10 days to 14 patients with complicated urinary tract infection caused by P. aeruginosa. The clinical results were excellent in 7 cases, good in 5 cases, and fair in 2 cases. Neither side effects nor abnormal values in laboratory findings were reported. The MIC of netilmicin against 14 strains of P. aeruginosa isolated from the above patients were distributed between 3.13 micrograms/ml and 12.5 micrograms/ml except 1 strain at inoculum size 10(6) cells/ml.

Aged↗
PubMed1980

Netilmicin treatment of complicated urinary tract infections.

Netilmicin was investigated in the treatment of complicated urinary tract infection in 169 elderly male patients. It was found to be safe and effective at the dose levels of 1.0-2.5 mg/kg, three times a day, or 2 mg/kg twice a day, eliminating approximately 50-60% of the infections. The serum half-life of netilmicin was 2-3 hours in subjects with normal renal function but increased to 10-14 hours in subjects with severe uremia. When the dosage was adjusted according to the patient's weight and serum creatinine, some nephrotoxicity occurred, possibly due to drug accumulation. Therefore, we suggest that the dose be adjusted according to reduction in creatinine clearance and when possible, monitoring serum concentrations during treatment.

Aged↗
PubMed1980

Netilmicin in urinary tract infections.

30 urological patients with normal renal function were treated with netilmicin because of urinary tract infections, mostly recurrent and due to predisposing factors. the drug was given in doses of 4 mg/kg/day for 4-9 days. All but 5 patients had resolution of their signs and symptoms, and the bacteria were eliminated in 23 patients, with recurrence in 8 and reinfection in 3. The bacteria persisted in 1 patient and the results were indeterminate in 6 patients. No signs of hematopoietic, renal and hepatic toxicity occurred, and vestibular and auditory functions were undisturbed. Regular assays of serum drug concentrations revealed no signs of accumulation. Netilmicin given in doses of 4 mg/kg/day is an efficient antibiotic with low toxicity in the treatment of urinary tract infections.

Adolescent↗
PubMed1980

Netilmicin therapy of serious renal and urinary tract infections in patients with normal and impaired renal function.

29 patients with serious renal or urinary tract infections were treated with netilmicin (initial dose 1.5 mg/kg twice daily). All but two patients were bacteriologically cured and responded well clinically. 13 patients with initial renal impairment were analysed separately. Whereas the patients with initial normal renal function did not show any increase of serum creatinine levels during and after treatment, the patients with renal impairment showed a significant increase of serum creatinine during the course of treatment, but no clinical signs of renal function deterioration. During the follow-up period (18 months), serum creatinine values in all cases but one returned to the pretreatment levels. Thus, the investigation revealed that netilmicin had a good clinical and bacteriological effect without signs of persistent renal damage.

Adult↗
PubMed1980

Netilmicin in the treatment of neonates with moderate and severe infections.

Thirty neonates and infants have been treated for verified or suspected infections with a combination of netilmicin and ampicillin intravenously for 7 days. The infecting organisms were isolated in 18 patients, of whom 2 had osteomyelitis and 2 had pneumonia. In 3 cases of pneumonia and 9 cases of suspected septicaemia bacteriological cultures were negative. None of the children died, and in all but the 2 cases of osteomyelitis, therapy led to complete resolution of the signs of infection and recovery without sequelae. No adverse reactions to antibiotic therapy were recorded. Upon follow-up examinations at the age of 3 months there has been no sign of auditory impairment as assessed by Brain Stem Evoked Response. Netilmicin is thus tolerated well in neonates and infants, and when guided by serum concentrations considered to be a safe and reliable aminoglycoside.

Drug Evaluation↗
PubMed1980

Netilmicin: efficacy and tolerance in the treatment of systemic infections in neonates.

38 newborn infants, 28 males and 10 females, were treated with netilmicin in doses 6-7 mg/kg/day for suspected or verified infections. 19 patients were mature (mean birth weight 3169 g) and 19 were premature (mean birth weight 1864 g). 32 had moderate or severe underlying diseases. 37 babies survived, 33 were cured or improved markedly and in 4 the results were indeterminate. Pathogenic bacteria were demonstrated in 24 cases and were eliminated in 15. Only one baby died. He suffered from severe respiratory distress syndrome and Escherichia coli septicemia. No E. coli was isolated at autopsy. The mean netilmicin peak serum value was 7.7 micrograms/ml (range 1.0-30.0) and the mean trough concentration 2.1 micrograms/ml (range 0.0-9.2). No adverse effects were seen.

Bacterial Infections↗
PubMed1980

Netilmicin 200 mg twice a day for adult patients with life-threatening infections. A preliminary report.

The efficacy and toxicity of netilmicin was assessed in 15 patients with life-threatening infections, including six with septicaemia. Fourteen patients were cured with no recurrence of infection. The initial dosage of netilmicin was 200 mg twice a day (2.3-4.0 mg/kg/dose), but subsequent adjustment of dosage was made according to the results of serum assay, either to avoid accumulation or to improve therapeutic response. Probable nephrotoxicity occurred in only one patient and there was no evidence of ototoxicity in the twelve patients who could be assessed.

Adult↗
PubMed1980

Netilmicin treatment followed by monitoring of vestibular and auditory function using highly sensitive methods.

Auditory and vestibular function was monitored in 30 patients treated with netilmicin for urinary tract infection. During and after the treatment, no signs or symptoms appeared that could be ascribed to an ototoxic effect of the drug. Routine acoustico-vestibular tests as well as advanced, objective acoustic tests revealed no signs of impairment of the labyrinth function. Results of highly sensitive vestibular tests in 15 patients including computerized analysis of the nystagmus responses to caloric tests were compared with results obtained from a sample of normal individuals. Some of the results varied significantly more in the netilmicin group than in the reference group. The most characteristic variation was a decreased reaction to hot water stimulation.

Adolescent↗
PubMed1980

Netilmicin in moderate to severe infections in newborns and infants: a study of efficacy, tolerance and pharmacokinetics.

49 newborns and infants were treated with netilmicin for verified or suspected infections. Infection was verified in 23 patients (mean gestational age 32 weeks and mean body weight 2100 g) and clinical cure or marked improvement occurred in 20 of these. Of the remaining 3 patients, 2 died, partly due to reasons unassociated with infection. 25 causative organisms were isolated and bacteriological elimination was achieved in 73% of the cases. At an average dose of 2.6 mg/kg twice a day, peak serum concentrations (30 min following injection) were 7.4 +/- 3.4 micrograms/ml. Serum half life was approximately 4.5 hours for infants born at term, and longer at shorter gestational age. Netilmicin is considered a safe and efficient aminoglycoside with a low rate of adverse effects.

Bacterial Infections↗
PubMed1981

An evaluation of netilmicin, 150 mg BID, in systemic infections.

The efficacy and tolerance of netilmicin administered in a simplified dosage schedule (150 mg BID) were evaluated in an open study of 20 patients with acute systemic infections. Duration of therapy ranged from 6 to 11 days. All isolated causative organisms were eradicated; 85% (17/20) of the patients experienced complete clinical resolution, and the remaining 15% (3/20) experienced definite improvement. No patients developed nephrotoxicity of ototoxicity. The results of this study demonstrate that netilmicin is both effective in the treatment of serious systemic infections and well tolerated when administered at 150 mg twice daily.

Adolescent↗
PubMed1982

[Antibacterial activity of netilmicin in combination with other antibiotics. Comparison with other aminoglycosides (author's transl)].

We studied in vitro bactericidal effects of netilmicin combined with other antibiotics, comparing with that obtained with other aminoglycosides combinations. We used strains of Streptococci and Gram negative rods tested versus 11 antibiotics : penicillin (P), ampicillin (Am), carbenicillin (Cb), cefalotin (Cth), cefazolin (Cfz), cefradin (Cfa), cefoxitin (Cxt), cefotaxime (CTX), erythromycin (E), pristinamycin (Pr), vancomycin (V). These were combined with streptomycin (Sm), tobramycin (To), amikacin (Ak), gentamicin (G) and netilmicin (Nl). First of all, we noted the high bactericidal power of Nl, whatever the strains tested. Against Streptococci, the activity of P + Nl and Am + Nl were equivalent or superior to that of P + G and Am + G. Among cephalosporins, we noted a synergistic effect of Ctx + Nl which did not exist with Ctx + G. In the same way, E + Nl showed synergism whereas E + G didn't. V + Nl combinations, as active upon Streptococci as V + G, are more active than V + G upon Enterococci. Against Gram negative bacilli, we observed good effects with Cb + Nl. Cephalosporins combinations were also interesting : Cfz + Nl were as active Cfz + G but Czt + Nl showed higher synergistic effect than Cxt + G. Ctx + Nl combinations were effective upon E. coli.

Aminoglycosides↗