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Prospective comparative study of efficacy and toxicity of netilmicin and amikacin
Abstract:
Eighty patients were treated with either amikacin or netilmicin in a prospective randomized study of serious gram-negative bacillary infections, including 11 due to gentamicin-resistant pathogens. Thirty-six treated with netilmicin and 35 treated with amikacin were evaluable for efficacy or toxicity, or both. The overall groups differed significantly only in age. There were no significant differences in efficacy of the two drugs. There were no statistically significant differences at the 95% level between the netilmicin group and the amikacin group with respect to nephrotoxic reactions (38 versus 28%, respectively) or ototoxic reactions (9 versus 25%, respectively). Further comparative trials of netilmicin and other aminoglycosides appear warranted before it is widely used.
Insights
This study compared amikacin and netilmicin for serious gram-negative infections. Both aminoglycoside antibiotics showed similar efficacy and toxicity profiles, suggesting further trials are needed.
Area of Science:
- Infectious Diseases
- Pharmacology
- Clinical Medicine
Background:
- Serious gram-negative bacillary infections pose significant treatment challenges.
- Aminoglycosides are crucial for treating such infections, but resistance and toxicity are concerns.
Purpose of the Study:
- To compare the efficacy and toxicity of amikacin and netilmicin in patients with serious gram-negative bacillary infections.
- To evaluate these antibiotics, including against gentamicin-resistant pathogens.
Main Methods:
- A prospective randomized study involving 80 patients.
- Patients received either amikacin or netilmicin.
- Efficacy and toxicity were assessed in evaluable patients (36 netilmicin, 35 amikacin).
Main Results:
- No significant differences in efficacy were observed between amikacin and netilmicin.
- Nephrotoxic reactions occurred in 38% of the netilmicin group versus 28% of the amikacin group (not statistically significant).
- Otoxic reactions occurred in 9% of the netilmicin group versus 25% of the amikacin group (not statistically significant).
Conclusions:
- Amikacin and netilmicin demonstrate comparable efficacy for serious gram-negative infections.
- While not statistically significant, observed toxicity rates warrant careful consideration.
- Further comparative trials of netilmicin against other aminoglycosides are recommended before widespread adoption.