Three to eight weeks of therapy with netilmicin: toxicity in normal and diabetic patients

Twenty-eight patients, 24 men and 4 women, aged between 17 and 72 years old, and suffering from chronic osteomyelitis (19), mastoiditis (5), or serious wound infections (4) were treated for an average of 35 days with netilmicin at doses of 2.4 to 6.9 mg/kg/day. The total dose of netilmicin given to each patient ranged from 3700 to 23 220 mg. Although the renal function was initially normal in all patients and stayed normal throughout therapy in all patients with no underlying disease, netilmicin nephrotoxicity was detected in two diabetic patients (7.6%). Vestibular toxicity developed in two (7.6%) but no change in audiograms was noted. Long-term therapy was associated with a significant increase (P less than 0.001) in half-life, from 1.5 to 1.9 h, and AUC 7.9 to 13.1 mg/l/h.