Netilmicin in the treatment of gram-negative bacteremia: single daily versus multiple daily dosage

Seventy patients with culture-proven bacteremia with gram-negative rods were randomly treated with either a single (S) dose daily or multiple (M) doses daily of netilmicin. All bacterial strains were susceptible to the antibiotic. No differences were found with respect to efficacy. Therapy for bacteremia failed in two M patients, but bacteria persisted in 17 (10 S, 7 M) at the primary infection site. In 12 there was an anatomic or physiologic factor contributing to this persistence. One S patient showed mild nephrotoxicity, but ototoxicity was not found in any of the 35 patients who underwent serial audiography. Mild reversible rises of transaminases were found in 5 of 35 S patients and in 3 of 34 M patients. Once-daily administration of netilmicin seems to be as effective and as safe as conventional multiple daily doses.