Antimicrob Agents Chemother 1991 Apr;35(4):640-7

Pharmacodynamic parameters and toxicity of netilmicin (6
milligrams/kilogram/day) given once daily or in three divided doses to cancer
patients with urinary tract infection.

Van der Auwera P, Meunier F, Ibrahim S, Kaufman L, Derde MP, Tulkens PM

Service de Medecine, Universite Libre de Bruxelles, Belgium.

The pharmacologic parameters and toxicity of netilmicin (6 mg/kg/day) given once
daily (qd) or thrice daily (tid) for the treatment of urinary tract infections
were studied in a randomized prospective study of 60 cancer patients. The
overall efficacy was 96%. Nephrotoxicity, assessed by the measure of urinary
excretion of phospholipids, was lower for the patients receiving the qd regimen
than for those receiving the tid regimen. Elevation of serum creatinine (20%
over baseline) occurred in one patient receiving the qd regimen and in three
receiving the tid regimen. Cochleotoxicity, assessed by pure-tone audiometry
(250 to 18,000 Hz) occurred in one patient receiving the qd regimen and none
receiving the tid regimen. Concentrations in sera were measured on days 1 and 5.
No significant accumulation was observed in either group. Median serum
bactericidal titers, expressed as reciprocal values (percentage of the sera with
a titer greater than or equal to 8), were measured against 25 test organisms in
samples collected 6 h after the administration of netilmicin and were, for the
qd group, 16 (82%) against members of the family Enterobacteriaceae and less
than 2 (8%) against Pseudomonas aeruginosa, and for the tid group, 4 (57%)
against members of the Enterobacteriaceae and less than 2 (0%) against P.
aeruginosa. The rate of killing in serum was rapid (2 to 3 log in 2 h against P.
aeruginosa; 3 to 5 log in 2 h against members of the Enterobacteriaceae) and
correlated with the sampling time and hence the concentration in serum of
netilmicin. The duration of the postantibiotic effect in serum depended also on
the strain and the sampling time of the serum.

Publication Types:
Clinical trial
Randomized controlled trial

PMID: 2069370, UI: 91298687