Pharmacokinetics and dosage adjustment of netilmicin in patients with cystic fibrosis

Netilmicin is a semisynthetic aminoglycoside antibiotic recently marketed in the United States by Schering-Plouogh corporation as Netromycin. The mechanism and spectrum of antibacterial action of netilmicin are similar to those of other aminoglycosides. Pulmonary infections with Pseudomonas aeruginosa are a common complication in patients with cystic fibrosis. Aminoglycosides currently occupy a central role in the management of these infections, often in combination with an extended spectrum penicillin derivative. Thadepalli, et al have demonstrated the synergism of netilmicin in combination with carbenicillan, ticarcillin and piperacillin to inhibit a number of Pseudomonas aeruginosa strains. Netilmicin may therefore play a role in the treatment of these infections. The objectives of this study were to further extend the limited information available on the elimination pharmacokinetics of netilmicin in patients with cystic fibrosis and to determine the utility of the Sawchuk-Zaske method of dosage adjustment for netilmicin in this population.