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High dose netilmicin therapy of severe or chronic infections
Abstract:
Sixteen patients with chronic or recurrent urinary tract infections, 14 with septicaemia, 2 with salmonellosis, 2 with pneumonia and 1 with acute mastitis were treated with 200 mg (2.2-3.6 mg/kg) netilmicin intramuscularly every 8 hours for 7-10 days (mean 8.8 days). 28 patients were cured, 5 showed marked improvement and 2 patients with septicaemia and severe underlying diseases failed to respond to treatment. The bacterial isolates were inhibited by 4.0 mg netilmicin/l or less. Antibiotic serum level determinations were performed in 32 patients. Mean serum concentrations of netilmicin 1 and 8 hours after injection were 12.6 and 2.0 mg/l respectively in 27 patients with normal serum creatinine levels. In 5 patients with elevated serum creatinine, mean peak and trough values were 21.5 and 5.8 mg/l, respectively. Mean netilmicin concentrations in serum and skin blister fluid obtained from 4 patients were equal 2-3 hours after injection, indicating appropriate tissue penetration. Nephrotoxicity occurred in 2 patients. Ototoxicity was not demonstrated. Netilmicin appears to be an effective and safe drug in the treatment of a variety of bacterial infections.
Insights
Netilmicin effectively treated various bacterial infections, including urinary tract infections and sepsis. The antibiotic demonstrated good tissue penetration and safety, with minimal nephrotoxicity observed in patients.
Area of Science:
- Pharmacology
- Infectious Diseases
- Clinical Medicine
Background:
- Bacterial infections pose a significant global health challenge.
- Aminoglycoside antibiotics are crucial for treating severe bacterial infections.
- Netilmicin is an aminoglycoside antibiotic with a broad spectrum of activity.
Purpose of the Study:
- To evaluate the efficacy and safety of netilmicin in treating various bacterial infections.
- To assess netilmicin's pharmacokinetic profile, including serum and tissue concentrations.
- To determine the incidence of adverse events, specifically nephrotoxicity and ototoxicity.
Main Methods:
- A clinical trial involving 31 patients with diverse bacterial infections (UTIs, sepsis, salmonellosis, pneumonia, mastitis).
- Patients received intramuscular netilmicin (200 mg every 8 hours) for 7-10 days.
- Antibiotic serum levels, creatinine levels, and tissue fluid concentrations were monitored; adverse events were recorded.
Main Results:
- High clinical success rates: 28 patients cured, 5 showed marked improvement.
- Bacterial isolates were susceptible to netilmicin (≤4.0 mg/l).
- Favorable pharmacokinetics observed, with appropriate tissue penetration and manageable serum concentrations; 2 cases of nephrotoxicity, no ototoxicity.
Conclusions:
- Netilmicin is an effective therapeutic agent for a range of bacterial infections.
- The drug exhibits good pharmacokinetic properties and an acceptable safety profile.
- Netilmicin demonstrates potential as a valuable antibiotic option in clinical practice.