Single-dose netilmicin therapy of complicated and uncomplicated lower urinary tract infections in children

Thirty children (age 3 months to 10 years) with complicated and uncomplicated lower urinary tract infections were treated with a single intramuscular injection of netilmicin 4.5 mg/kg. The diagnosis of lower urinary tract infection was based on the absence of fever and the presence of normal values for erythrocyte sedimentation rate, C-reactive protein concentration and urinary excretion of N-acetyl-beta-D-glucosaminidase. Follow-up urine cultures in all children demonstrated a cure rate of 97% and reinfection and relapse rates each of 7% respectively. The subgroup (12 children) with radiological abnormalities of urinary tract showed a cure rate of 92%, and reinfection and relapse rates of 9% respectively. The rates of cure, reinfection and relapse in the complicated and uncomplicated urinary tract infections were not statistically different (p greater than 0.05). A pharmacokinetic study (performed in 5 children) demonstrated that netilmicin urinary concentrations were over the MIC's of the infecting organisms up to 96 hours after the single-dose injection. Netilmicin was well tolerated and no side effects appeared during treatment. Single-dose netilmicin therapy is an effective and safe regimen for complicated and uncomplicated urinary tract infections in children. The response to single-dose netilmicin therapy seems to be related to its prolonged urinary elimination.