High dose netilmicin therapy: efficacy, tolerance and tissue penetration

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Abstract
Sixteen patients with chronic urinary tract infections, eight with septicaemia, two with lower respiratory tract infections, three with salmonellosis and one with acute mastitis were treated with 200 mg (2.2 to 3.6 mg/kg) netilmicin intramuscularly every 8 h for 10 days. Twenty-five patients were cured, four showed marked improvement and one patient with septicaemia and severe underlying disease failed to respond to treatment. Mean serum concentrations of netilmicin 1/2,1 and 8 h after injection were 11.4, 14.3 and 2.7 mg/1, respectively. High concentrations of netilmicin were demonstrated in skin blister fluid. The penetration of antibiotic into phagocytic cells was less pronounced and similar to that of gentamicin. Despite high netilmicin doses and serum levels nephrotoxicity occurred in only one patient (3%) and ototoxicity was not demonstrated. Netilmicin is a useful drug in the treatment of a variety of bacterial infections.

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