Skip to main content
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1978 May;13(5):832–836. doi: 10.1128/aac.13.5.832

Pharmacology and Efficacy of Netilmicin

Irwin Trestman 1, James Parsons 1, Jerome Santoro 1, Glenn Goodhart 1, Donald Kaye 1
PMCID: PMC352339  PMID: 666303

Abstract

Twenty-six patients, 20 to 77 years of age, were treated with netilmicin, mean dose 2 mg/kg every 8 h intramuscularly or in a 20-min intravenous infusion. The mean serum half-lives in patients with creatinine clearances of ≥90 ml/min and 60 to 90 ml/min were 3.2 and 3.4 h, respectively. In patients with serum creatinines of ≤1.4 mg/100 ml and creatinine clearances of ≥60 ml/min, mean serum levels were 9.0 and 1.2 μg/ml, respectively, 5 to 15 min and 7.5 h post-intravenous infusion, and 7.1 and 1.7 μg/ml, respectively, 1 and 8 h post-intramuscular injection. Twenty-five patients had acute pyelonephritis; 7 of the 25 had bacteremia. The infecting bacteria were Escherichia coli (15), Proteus mirabilis (5), Pseudomonas aeruginosa (2), Klebsiella pneumoniae (1), Enterobacter hafniae (1), and both Proteus rettgeri and Proteus morganii (1). All were inhibited by 6.3 μg of netilmicin per ml, except for the P. rettgeri, which required 25 μg/ml for inhibition. Of 23 patients who could be evaluated, 19 were bacteriologically and clinically cured at follow-up. Of the remaining four, one relapsed, two became reinfected, and one was lost to follow-up. Five patients developed nephrotoxicity; two of the five had previous renal insufficiency. Three patients, one with abnormal renal function, developed ototoxicity detected only with audiograms. These studies suggest that netilmicin is effective in serious gram-negative bacillary infections, but is nephrotoxic and ototoxic in humans.

Full text

PDF
832

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arcieri G. M., Falco F. G., Smith H. M., Hobson L. B. Clinical research experience with gentamicin. Incidence of adverse reactions. Med J Aust. 1970 Jun 13;1(Suppl):30–34. [PubMed] [Google Scholar]
  2. Bodey G. P., Middleman E., Umsawadi T., Rodriguez V. Infections in cancer patients. Results with gentamicin sulfate therapy. Cancer. 1972 Jun;29(6):1697–1701. doi: 10.1002/1097-0142(197206)29:6<1697::aid-cncr2820290638>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  3. Bowman R. L., Silverblatt F. J., Kaloyanides G. J. Comparison of the nephrotoxicity of netilmicin and gentamicin in rats. Antimicrob Agents Chemother. 1977 Oct;12(4):474–478. doi: 10.1128/aac.12.4.474. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Dahlgren J. G., Anderson E. T., Hewitt W. L. Gentamicin blood levels: a guide to nephrotoxicity. Antimicrob Agents Chemother. 1975 Jul;8(1):58–62. doi: 10.1128/aac.8.1.58. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Eickhoff T. C., Ehret J. M. In vitro activity of netilmicin compared with gentamicin, tobramycin, amikacin, and kanamycin. Antimicrob Agents Chemother. 1977 May;11(5):791–796. doi: 10.1128/aac.11.5.791. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Fanning W. L., Gump D., Jick H. Gentamicin- and cephalothin-associated rises in blood urea nitrogen. Antimicrob Agents Chemother. 1976 Jul;10(1):80–82. doi: 10.1128/aac.10.1.80. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Fu K. P., Neu H. C. In vitro study of netilmicin compared with other aminoglycosides. Antimicrob Agents Chemother. 1976 Sep;10(3):526–534. doi: 10.1128/aac.10.3.526. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Hewitt W. L. Gentamicin: toxicity in perspective. Postgrad Med J. 1974 Nov;50 (Suppl 7):55–61. [PubMed] [Google Scholar]
  9. Jackson G. G., Arcieri G. Ototoxicity of gentamicin in man: a survey and controlled analysis of clinical experience in the United States. J Infect Dis. 1971 Dec;124 (Suppl):S130–S137. doi: 10.1093/infdis/124.supplement_1.s130. [DOI] [PubMed] [Google Scholar]
  10. Kabins S. A., Nathan C., Cohen S. In vitro comparison of netilmicin, a semisynthetic derivative of sisomicin, and four other aminoglycoside antibiotics. Antimicrob Agents Chemother. 1976 Jul;10(1):139–145. doi: 10.1128/aac.10.1.139. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kaye D., Levison M. E., Labovitz E. D. The unpredictability of serum concentrations of gentamicin: pharmacokinetics of gentamicin in patients with normal and abnormal renal function. J Infect Dis. 1974 Aug;130(2):150–154. doi: 10.1093/infdis/130.2.150. [DOI] [PubMed] [Google Scholar]
  12. Klastersky J., Meunier-Carpentier F., Coppens-Kahan L., Daneau D., Prevost J. M. Clinical and bacteriological evaluation of netilmicin in gram-negative infections. Antimicrob Agents Chemother. 1977 Oct;12(4):503–509. doi: 10.1128/aac.12.4.503. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Labovitz E., Levison M. E., Kaye D. Single-dose daily gentamicin therapy in urinary tract infection. Antimicrob Agents Chemother. 1974 Oct;6(4):465–470. doi: 10.1128/aac.6.4.465. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Levison M. E., Knight R., Kaye D. In vitro evaluation of tobramycin, a new aminoglycoside antibiotic. Antimicrob Agents Chemother. 1972 May;1(5):381–384. doi: 10.1128/aac.1.5.381. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Luft F. C., Yum M. N., Kleit S. A. Comparative nephrotoxicities of netilmicin and gentamicin in rats. Antimicrob Agents Chemother. 1976 Nov;10(5):845–849. doi: 10.1128/aac.10.5.845. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Meyers B. R., Hirschman S. Z., Wormser G., Siegel D. Pharmacokinetic study of netilmicin. Antimicrob Agents Chemother. 1977 Jul;12(1):122–123. doi: 10.1128/aac.12.1.122. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Meyers R. M. Ototoxic effects of gentamicin. Arch Otolaryngol. 1970 Aug;92(2):160–162. doi: 10.1001/archotol.1970.04310020058014. [DOI] [PubMed] [Google Scholar]
  18. Miller G. H., Arcieri G., Weinstein M. J., Waitz J. A. Biological activity of netilmicin, a broad-spectrum semisynthetic aminoglycoside antibiotic. Antimicrob Agents Chemother. 1976 Nov;10(5):827–836. doi: 10.1128/aac.10.5.827. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Riff L. J., Moreschi G. Netilmicin and gentamicin: comparative pharmacology in humans. Antimicrob Agents Chemother. 1977 Apr;11(4):609–614. doi: 10.1128/aac.11.4.609. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Welling P. G., Baumueller A., Lau C. C., Madsen P. O. Netilmicin pharmacokinetics after single intravenous doses to elderly male patients. Antimicrob Agents Chemother. 1977 Sep;12(3):328–334. doi: 10.1128/aac.12.3.328. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Wilfert J. N., Burke J. P., Bloomer H. A., Smith C. B. Renal insufficiency associated with gentamicin therapy. J Infect Dis. 1971 Dec;124 (Suppl):S148–S155. doi: 10.1093/infdis/124.supplement_1.s148. [DOI] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES