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KMID : 0378019940370080090
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New Medical Journal
1994 Volume.37 No. 8 p.90 ~ p.94
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Clinical Effectiveness of Netilmicin in Intraabdominal Infections
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Abstract
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Netilmicin is a new semisynthetic aminoglycoside, 1-N-ethyl derivative of a sisomicin, and has wide spectrum of antimicrobial activity against gramnegative bacilli.
Various aminoglycoside antibiotics have been used successfully to treat the gram negative infection but the emergence of resistant gram negative bacilli in certain clinical settings makes the control of infection very difficult.
Netilmicin is known to resist to be inactivated by gentamicin adenyl transferase and is relatively resistant to gentamicin acetyl transferase, but has no active site for kanamycin phesphotransferase inactivation and is inactivated by kanamycin acetyl transferase.
To evaluate the effectiveness of netilmicin in various kinds of intra abdominal infections, we selected 21 cases of peritonitis and compared the clinical efficacy of netilmicin with strong aminoglycoside amikacin.
The results are as follows
1) The age distribution between netilmicin and amikacin treatment groups are similar, and sex ratio is not different.
2) The disease distribution of netilmicin group were acute appendicitis (4 cases), complicated appendicitis (9 cases), GB empyema (3 cases), choloangitis (2 cases). That of amikacin group were acute appendicitis (11 cases), cholangitis (1 case) and intraabdominal abscess (1 case).
3)The outcome of treatment with netilmicin showed 18 good response ,cases (85.7%), 1 fair response case and, 2 poor response cases and the result with amikacin showed 17 good response cases(80.9%), 3 fair response cases and 1 poor
response case. Overall response rate of good and fair group of netilmicin was 90.4% and of amikacin was 59.2%.
4) The microbial organism isolated from intraabdominal infections were E. coli, Klebsiella pneumoniae, Enteroccoccus fecalis, Morganella morgani and Pseudomonas aeruginosa. Both aminoglycoside have similar bactericidal activity but amikacin has slightly broader spectrum of antimicrobial activity.
5) There was no critical toxicity. All the patients had no hearing difficulty during treatment. Amilkacin had some nephrotoxicity with elevated creatinine level and netilmicin users showed some elevated transaminase level but recovered soon.
The above results showed that netilmicin is a safe drug and has similar or
somewhat superior activity to other aminoglycosides. We think that netilmicin will be used safely and effectively in the treatment of various kinds of intraabdomnal infections.
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