Netilmicin
Mechanism :
Aminoglycoside antibiotic. Enzymes that degrade gentamicin and tobramycin do not degrade netilmicin. It is active against both gram positive and gram-negative bacterial infections.
Indication :
- Serious gram-negative infections resistant to Gentamicin
Contraindications :
Hypersensitivity to netilmicin and myasthenia gravis is a contraindication to its use. Patients should be well hydrated during therapy, and renal function should be monitored. Dose adjustment is required in impaired renal function.
Dosing :
IV/IM
Premature or full-term neonates, 1 week of age or less:
6 mg/kg IV daily in two divided doses.
Neonates over 1 week of age and infants:
7.5-9.0 mg/kg daily IV in three divided doses.
Children:
6.0-7.5 mg/kg daily IV in three divided doses.
The duration of treatment is usually 7-14 days.
Adverse Effect :
Ototoxicity and nephrotoxicity. All aminoglycosides have the potential to induce auditory, vestibular, and renal toxicity and also cause neuromuscular blockade.
Interaction :
Vancomycin, Cephalosporin, Cyclosporine, Furosemide, Cisplatin, Amphotericin: Increases chances of ototoxicity and nephrotoxicity.
Non-Depolarising Muscle Relaxants: Enhances effect.
Neostigmine, Pyridostigmine: Antagonises effect.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | 4–7.5 mg/kg once daily. Monitor levels |
| 10-20 | 3–4 mg/kg once daily. Monitor levels |
| <10 | 2 mg/kg once daily. Monitor levels |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Dialysed. IV: 2 mg/kg on alternate days IP: 7.5–10 mg/L per exchange. Monitor levels |
| HD | Dialysed. Administer 2 mg/kg at the end of each dialysis session. Monitor levels |
| HDF/High flux | Dialysed. Administer 2 mg/kg at the end of each dialysis session. Monitor levels |
| CAV/VVHD | Dialysed. Dose as in GFR=10– 20 mL/min. Monitor levels |
Hepatic Dose :
No dosage adjustments are recommended.