netilmicin and Pleural-Effusion

Topics: Adult; Aged; Female; Gentamicins; Humans; Hydrogen-Ion Concentration; Male; Middle Aged; Netilmicin; Pleural Effusion; Tobramycin

The concentrations of gentamicin, netilmicin, and amikacin were determined after one single intravenous injection in uninfected pleural fluid after thoracotomy and in purulent pleural empyemas. The mean peak concentrations in the pleural fluid after the injection of gentamicin (1.5 mg/kg), netilmicin (2.0 mg/kg), and amikacin (7.5 mg/kg) were 2.9 +/- 0.3 mg/L, 3.7 +/- 0.8 mg/L, and 11.0 +/- 3.1 mg/L, respectively. The pleural penetration of the drugs was very high (from 80.0 to 99.1 percent). By contrast, gentamicin and netilmicin were not detectable in empyema pus; in this exudate the mean peak level of amikacin was 5.7 +/- 2.2 mg/L, with the penetration of this drug being 31.0 percent. The concentrations of parenterally administered aminoglycosides are substantially lower in empyema pus than in sterile pleural fluid. The possibility of poor pleural penetration of some aminoglycosides, as well as the presence of local conditions in pleural empyema unfavorable to the bioactivity of these drugs, must be kept in mind when treating pleural infections.

Topics: Amikacin; Anti-Bacterial Agents; Biological Availability; Empyema; Gentamicins; Half-Life; Humans; Injections, Intravenous; Netilmicin; Pleural Effusion; Postoperative Complications; Time Factors

To 10 cases with respiratory infections, 200 mg, twice daily, of netilmicin was administered without other antibiotics and the following results were obtained. 1) Netilmicin was administered to 2 cases of pneumonia and 8 cases of bronchitis for 7 to 30 days, and 4 remarkably effective and 6 effective cases were observed, that is, netilmicin was effective in all cases. 2) Abnormal laboratory test values were found in 2 cases; 1 case showed slightly elevated creatinine value, and 1 case showed slightly increase GTP value, and these values were normalized rapidly without any treatment after discontinuation of netilmicin administration. Netilmicin 100 mg was intramuscularly injected to 15 patients with pleural effusion to see the time-course distribution of the drug to serum and to pleural fluid by determining the concentration of netilmicin. 1) Netilmicin concentrations in serum reached the peak at 30 minutes after the intramuscular injection and it gradually decreased, while in the pleural fluid, it reached the peak at 3 hours after the injection, and the peak value in the pleural fluid in average was 2.63 +/- 1.98 micrograms/ml, and it was still detectable at 24 hours after the injection. 2) The ratio of netilmicin concentrations in the serum and pleural fluid at the peak was 31.7 +/- 23.4%, and distribution of netilmicin into the pleural fluid was considered to be high enough.

Topics: Adult; Aged; Drug Evaluation; Female; Gentamicins; Humans; Injections, Intramuscular; Male; Middle Aged; Netilmicin; Pleural Effusion; Respiratory Tract Infections