Pharmacokinetics of netilmicin in renal insufficiency and hemodialysis

The pharmacokinetics of netilmicin was studied in 26 patients with varying degrees of renal impairment (11 were dialysis patients) in order to determine the influence of kidney function status on the disposition of the antibiotic. The serum level curves of netilmicin follows a two-compartment open kinetic model. Several relationships between pharmacokinetic parameters and renal function indicators are defined. A clinical useful correlation indicates that the half-life is approximately 3 times the serum creatinine concentration, and may be used for adjusting the netilmicin dosage in the treatment of patients with impaired renal function. During hemodialysis the serum half-life decreases approximately 10-fold compared with the interdialysis periods. The percentage of dose extracted by hemodialysis during a single 4 h session is 56.1 +/- 6.65%. The dialysis clearance is 87.28 +/- 28.8 ml/min.