Abstract
Studies in animals and in adults have shown that netilmicin (NM) is as effective but less nephrotoxic or oxotoxic than other aminoglucosides. There are few data on the use of NM in neonates, which can help the neonatologist to predict situations during which NM monitoring will be necessary.
54 pharmacokinetic (PK) NM studies were performed: in 31 fullterm and 14 preterm babies. 3 mg/kg/12 h of NM was administered by 30 mn infusion in 40 cases and by IM route in 14 cases. Serum concentrations were analyzed by fluorescence polarization. For IV and IM route the mean peak serum level was 5.57 mg/l and 6.34 mg/l, recpectively, the mean through level was 1.66 mg/l and 2.36 mg/l. Mean concentrations were significantly higher with the IM than with the IV route because of the slow IV administration. In the 9 children with two successive pharmacokinetic studies the mean plasma levels were significantly higher during the second study, suggesting an accumulation of NM. The serum half life was higher:
1) in preterms (7.19 h) than in fullterms (5.84 h).
2) in neonates with proven infections (8.5 h) than in those with suspected infections (5.4 h) suggesting poor hemodynaraic conditions in those babies with diminution of clearance of NM.
Our study shows that 3 mg/kg by 30 mn IV infusion of NM is safe in neonates without dangerous peak levels: it will be useful to monitor NM levels in preterm babies, neonates with proven infections and during treatment longer than 7 days.
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Autret, E., Lionnet, C., Laugier, J. et al. 82 PHARMACOKINETICS OF NETILMICIN IN NEONATES. Pediatr Res 20, 1047 (1986). https://doi.org/10.1203/00006450-198610000-00136
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DOI: https://doi.org/10.1203/00006450-198610000-00136