[Pharmacokinetics of netilmicin in cirrhotic patients with or without ascites]

The pharmacokinetics of netilmicin after intramuscular injection (2 mg/kg) was investigated comparatively in cirrhotic patients with or without ascites, and in healthy subjects. In patients with ascites, the same pharmacokinetic parameters were measured after the ascites had been cured. Twenty-four hours after intramuscular injection, the residual levels in cirrhotic patients were moderately higher than in controls, showing that liver failure or ascites did not significantly modify the pharmacokinetics of netilmicin. Serum concentrations were bactericidal. The ascitic fluid level was lower than the therapeutic range, but it was sustained for nearly 24 hours after intraperitoneal injection (2 mg/kg). These results indicate that netilmicin may be administered to cirrhotic patients without peritoneal infection using the same regimen as in healthy subjects. The peritoneal route may be preferable in case of peritoneal infection.