Abstract
Netilmicin, a recently released aminoglycoside is used in neonates as an alternative to gentamicin or tobramycin for treatment of suspected or proven sepsis. We studied netilmicin kinetics in 8 premature infants (4 M, 4 F) with an average gestation age of 31.3 weeks (range 28–33), a postnatal age of 3 days, and birth weight of 770-1640 grams. Patients were receiving netilmicin, 2.5 mg/kg/IV over 0.33 hours every 12 hours for presumed or proven sepsis. Patient who weighed 770 grams was placed on q 18° dosing schedule. At steady-state, blood samples were obtained at 0, 0.5, 1, 2, 4, 8 and 12 hours after starting the infusion and analyzed by TDxR method. Peak and trough serum concentrations of netilmicin ranged 6.7-12.6 (9.7±2.4) mcg/ml and 2.2–3.7 (2.81±.5) mcg/ml, respectively. Seven of eight patients had trough serum concentration ≥ 2 mcg/ml. Total body clearance of netilmicin ranged from 0.37 to 0.95 (.72±.21) ml/min/kg. Apparent volume of distribution ranged from 0.33 to 0.82 (.52±.18) L/kg and elimination half-life from 4.6 to 11.5 (8.3±2.7) hours. Netilmicin clearance appeared to increase and half-life tended to decrease with increasing body weight. A 2- to 3-fold variation in the kinetic parameters and the frequent occurrence of trough serum concentrations > 2 mcg/ml indicates the need for close monitoring of netilmicin therapy in newborn infants.
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Kuhn, R., Nahata, M., Bickers, R. et al. 387 PHARMACOKINETICS OF NETILMICIN IN NEWBORN INFANTS. Pediatr Res 19, 175 (1985). https://doi.org/10.1203/00006450-198504000-00417
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DOI: https://doi.org/10.1203/00006450-198504000-00417
