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Netilmicin Sulfate: A Comparative Evaluation of Antimicrobial Activity, Pharmacokinetics, Adverse Reactions and Clinical Efficacy
Author(s) -
Craig William A.,
Gudmundsson Sigurdur,
Reich Richard M.
Publication year - 1983
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1983.tb03283.x
Subject(s) - netilmicin , aminoglycoside , tobramycin , amikacin , ototoxicity , gentamicin , medicine , pharmacology , sisomicin , nephrotoxicity , antibacterial agent , antibiotics , microbiology and biotechnology , biology , toxicity , chemotherapy , cisplatin
Netilmicin, the 1‐N‐ethyl derivative of sisomicin, is a new aminoglycoside antibiotic that was recently marketed in the United States. Its role in therapeutics is not yet established. The pharmacokinetic profile of netilmicin is very similar to that of gentamicin. Its antimicrobial spectrum and clinical efficacy is similar to that of gentamicin, tobramycin and amikacin. It is less active in vitro against Pseudomonas aeruginosa than gentamicin and tobramycin, but in clinical trials the efficacy of netilmicin against this organism has been similar to other aminoglycosides. Netilmicin is active against some gentamicin and tobramycin‐resistant strains of gram‐negative bacilli, particularly those harboring adenylating and phosphorylating enzymes. Most of these strains are sensitive to amikacin as well, and amikacin is also active against most netilmicin‐resistant strains of these bacteria. Therefore, amikacin remains the aminoglycoside of choice against gentamicin tobramycin and netilmicin‐resistant gram‐negative bacilli. In comparison to other currently available aminoglycosides, a lower frequency of nephrotoxicity and ototoxicity has been observed in laboratory animals given netilmicin. This has not been unequivocally demonstrated in humans. The frequency of nephrotoxicity in humans has been similar to that of other aminoglycosides. The frequency of ototoxicity associated with netilmicin in humans has been low but not significantly less than with other aminoglycosides, except in one trial. If further studies document a significantly lower frequency of ototoxicity with netilmicin, it may become the aminoglycoside of choice for patients with significant risk factors for ototoxicity, such as advanced age, renal impairment, concomitant ototoxic drug therapy and prolonged aminoglycoside administration.