NETILMICIN IN PREMATURE AND FULL-TERM INFANTS: ITS EFFECTS ON THE RENAL AND AUDITORY FUNCTIONS AND ITS KINETICS ACCORDING TO MULTICOMPARTMENT MODEL

Abstract

68 neonates with gestational age ranging from 27 to 40 weeks, 6-15 days postnatal age and 800-3400 g birth weight were treated for 5-14 days with Netilmicin (N), 2.5 mg/kg/b.i.d. or t.i.d. according to postconceptional age. Their renal function was studied by measuring serum creatinine concentrations during and up to 15 days after therapy. The urinary excretion of N-acetyl-glucosaminidase (NAG) was measured as a marker of tubular injury. Valley N serum levels were monitored during the treatment. Serum and urinary washout profile of the drug were followed for up to 10-15 days after discontinuation. Behavioral and impedance audiometry are being performed between 6 to 12 months of age. Treatment with N (always in association with a β-lactam antibiotic) did not represent for the newborns a source of toxicity as far as either renal or auditory (38 infants so far examined) function are concerned. Small preterm neonates (≤34 weeks G.A.) more frequently had elevated valley serum N concentration (≥3 ug/ml). The serum and urinary washout followed a multiexponential decay with prolonged terminal T 1/2 indicating tissue accumulation.

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