netilmicin and Postoperative-Complications

The authors had for aim to assess the effectiveness and toxicity of a piperacillin-tazobactam-netilmicin combination, and the possibility of avoiding using glycopeptide, in children with febrile neutropenic episodes induced by chemotherapy.. A retrospective study was made, including children treated for a febrile neutropenic episode (absolute neutrophile count < 0.5 x 10(9)/l) by a piperacillin-tazobactam-netilmicin combination. If fever persisted 48 hours after the beginning of antibiotic therapy, a glycopeptide could be added. The responses to the treatment were defined as follows: 1) total success (no fever or documented infection) at 48 hours and at 72 hours following the beginning of treatment; 2) partial success (apyrexia beyond 72 hours without any therapeutic change); 3) failure (persistent infectious signs 48 hours after the introduction of glycopeptide).. Sixty-nine episodes were assessable, corresponding to 41 patients, treated for a solid tumour (29), an acute leukaemia in remission (11), or a metabolic disease (1). The febrile episodes were divided into fever of unknown origin (71%), microbiologically documented fever (12%), and clinically documented fever (17%). No death occurred, no toxicity was reported. With this antibiotic therapy, total success at 72 hours was observed in 72% in case of fever of unknown origin and 45% in case of documented infections. The success rate reached 84% when a glycopeptide was added (30% of the cases).. The piperacillin-tazobactam-netilmicin combination is very effective and well tolerated in probabilistic treatment of febrile neutropenia induced by chemotherapy, but does not allow to decreasing the frequency of glycopeptide administration.

Topics: Adolescent; Anti-Bacterial Agents; Antineoplastic Agents; Bacterial Infections; Child; Child, Preschool; Clinical Trials as Topic; Drug Combinations; Drug Evaluation; Escherichia coli Infections; Female; Fever; Fever of Unknown Origin; Hematopoietic Stem Cell Transplantation; Humans; Immunocompromised Host; Infant; Male; Neoplasms; Netilmicin; Neutropenia; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Postoperative Complications; Retrospective Studies; Treatment Outcome; Urinary Tract Infections

To demonstrate efficacy and safety of an ophthalmic hydrogel formulation of netilmicin/dexamethasone, containing xanthan gum twice a day (b.i.d.) versus netilmicin/dexamethasone eye drops four times a day (q.i.d) to treat inflammation and prevention of infection after cataract surgery.. Patients undergoing phacoemulsification with intraocular lens implantation (IOL) were randomised in two groups: group 1, twice daily (b.i.d.) dexamethasone 0.1%/netilmicin 0.3% (Netildex) ophthalmic gel; group 2, four times daily (q.i.d.) dexamethasone 0.1%/netilmicin 0.3% (Netildex) eye drops. Both treatments were administered for 14 days after surgery. Patients were evaluated before surgery, on the day of surgery and at 1, 7, 15 and 60 postoperative days. The primary efficacy endpoint was evaluation of cellularity and flare in the anterior chamber through slit-lamp biomicroscopy 7 days after surgery. Secondary endpoints included: presence of signs/symptoms of postoperative ocular inflammation and incidence of infection.. One hundred seventy-three patients were randomised and 168 were evaluable. Flare and cellularity were resolved at day 7 in 92.5% of patients and almost completely by day 15. In both intent to treat (ITT) and per-protocol (PP) populations, the efficacy analysis demonstrated that the gel formulation administered twice a day was non-inferior to the eye drops administered four times a day. For ITT analysis, the lower limit of the 97.5% confidence interval (- 0.0535) was greater than the non-inferiority limit of -0.10. For the PP analysis, the lower limit of the 97.5% confidence interval (- 0.0526) was greater than the non-inferiority limit of - 0.10. The patient's global tolerability and reported symptoms were similar between treatment groups. No microbial load and no safety events were observed.. Efficacy of the gel reduced posology (twice a day) is not inferior to four times a day eye drops. Both treatments were well tolerated and efficacious. The new reduced posology hydrogel formulation may improve patient compliance and quality of life.. Eudract: 2016-0021138-63; ClinicalTrial.gov: NCT029738880.

Topics: Cataract; Dexamethasone; Double-Blind Method; Humans; Hydrogels; Inflammation; Lens Implantation, Intraocular; Netilmicin; Ophthalmic Solutions; Postoperative Complications; Quality of Life; Treatment Outcome

To compare the efficacy and safety of preservative-free Netilmycin/Dexamethasone with that of preserved Tobramycin/Dexamethasone, postcataract surgery.. Prospective, randomized, single-blind study on patients submitted to phacoemulsification. During preoperatory visits, at 7 and 21 days conjunctival hyperemia, corneal edema, Tyndall, Shirmer I, corneal and conjunctival lissamine green and fluorescein staining, and intraocular pressure (IOP) were recorded. Postoperative pain (at day 7) and the subjective tolerability (at day 21) were investigated.. Eighty patients completed the study and the data collected were analyzed (44 on Netilmycin/Dexamethasone). Regarding the primary efficacy variable, intraocular inflammation, no microbial events were recorded, but aqueous flare was significantly lower with Tobramycin/Dexamethasone at 1 week (P = 0.002). Regarding secondary efficacy variables, conjunctival hyperemia was lower in patients under Tobramycin/Dexamethasone (P < 0.001), but corneal edema and ocular pain were similar. Regarding safety, no significant differences on ocular surface status were recorded. Both formulations were well tolerated, but Tobramycin/Dexamethasone caused an increased IOP at 1 week (P < 0.0001).. Both the studied fixed combinations are safe and effective in controlling postoperative inflammation and preventing postoperative ocular infections. Tobramycin/Dexamethasone has a quicker anti-inflammatory effect but needs IOP monitoring. Further studies on more patients using a sounder scientific design are needed to confirm our findings.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Anti-Inflammatory Agents; Dexamethasone; Drug Combinations; Female; Follow-Up Studies; Humans; Inflammation; Male; Middle Aged; Netilmicin; Pain, Postoperative; Phacoemulsification; Postoperative Complications; Prospective Studies; Single-Blind Method; Time Factors; Tobramycin

The aim of this study was to compare the clinical and microbiological efficacy of netilmicin plus imipenem-cilastatin (Net + Imi) vs netilmicin plus ceftazidime (Net + Cef) as empiric antimicrobial therapy in bone marrow transplant (BMT) febrile neutropenic patients (pts). Sixty-six pts undergoing BMT for hematological malignancies and solid tumors were randomized to receive Net + Imi or Net + Cef as first-line antibiotic therapy. A lasting return of temperature to normal and complete disappearance of either clinical or cultural signs of infection without any modification of therapy was considered as improvement; the persistence of fever after 72 hours, the addition of a third antibiotic or a protocol change was considered as failure. Sixty-nine episodes were randomized during the course of the trial; bacteriological evidence of infection was obtained in 17 (25%) febrile episodes. Overall outcome based on clinical responses was as follows: 80% of pts on Net + Imi responded compared to 73% of those on Net + Cef. For microbiologically documented infections response rates were 70% in Net + Imi group and 43% in the Net + Cef group (p = ns). Neither septic death nor toxicity were observed. Both empiric regimens were shown to be effective; Net + Imi appeared to be more effective in microbiologically documented infections but there was no statistical significance. In conclusion, both Net + Imi and Net + Cef are active and safe as empirical treatment of febrile episodes in neutropenic BMT pts.

Topics: Adolescent; Adult; Bacteria; Bacterial Infections; Bone Marrow Transplantation; Ceftazidime; Cephalosporins; Child; Cilastatin; Drug Synergism; Drug Therapy, Combination; Female; Fever; Gentamicins; Humans; Imipenem; Male; Middle Aged; Netilmicin; Neutropenia; Postoperative Complications; Protease Inhibitors; Thienamycins; Treatment Outcome

Two randomized studies have been initiated to establish the role of teicoplanin as systemic therapy for infections in burns patients and as short-term prophylaxis for orthopaedic implant surgery. Opportunistic micro-organisms causing infections in burn patients are often acquired in hospital. These infections commonly involve Gram-positive organisms which may be resistant to several antibiotics. Teicoplanin, alone and in combination with additional antibacterial drugs, is effective in the treatment of Gram-positive infections of various types. In addition, teicoplanin has proved useful as prophylaxis against infection in orthopaedic surgery. Deep prosthetic infections are very difficult to cure without removing the infected device; the outcome can be devastating, such as total loss of joint function, amputation, and, occasionally, death. Preliminary results from the two studies are encouraging and show that teicoplanin has a role to play both in treatment of infection and as prophylaxis against hospital-acquired infection.

Topics: Adult; Burns; Cefazolin; Cross Infection; Drug Therapy, Combination; Female; Glycopeptides; Gram-Positive Bacterial Infections; Humans; Joint Prosthesis; Male; Middle Aged; Netilmicin; Postoperative Complications; Teicoplanin; Thymus Extracts; Wound Infection

A prospective, randomized study was carried out in order to assess the efficacy and safety of the mezlocillin-netilmicin combination in the prophylaxis of first permanent transvenous cardiac pacemaker implantation. Five hundred and fifty-two consecutive patients were randomly administered either 2 g mezlocillin and 200 mg netilmicin both as an i.v. bolus before implantation or 2g mezlocillin before and then 6 and 12 hours after surgery and 200 mg netilmicin before and then 12 hours after implantation. No adverse events were seen. Neither pocket nor electrode infections were observed in the 457 subjects still alive (mean follow-up: 29.2 months) or in patients who died after 1 year of follow-up (mean follow-up: 20.1 months) or before this time (mean follow-up: 4.7 months). The serum and pocket concentrations of mezlocillin and netilmicin at the end of surgery were found to be adequate to cover microorganisms that most often cause infections, including methicillin-resistant staphylococci.

Topics: Bacterial Infections; Drug Therapy, Combination; Humans; Injections, Intravenous; Mezlocillin; Netilmicin; Pacemaker, Artificial; Postoperative Complications; Premedication; Prospective Studies; Risk Factors

To evaluate the efficacy of preoperative antibiotic prophylaxis, we studied 130 patients who were submitted to prostate surgery. These patients were divided into 3 groups. Overall morbidity was lower for the patient group that had received antibiotic prophylaxis (Netilmicin, 3 doses) than for the group on placebo and the group on antibiotics postoperatively. The incidence of significant bacteriuria for the group on Netilmicin was less at 7 days (7.5%) and at 30 days (20.5%) than for the other groups: (22.55%) and (49.36%) at 7 and 30 days, respectively. The foregoing data indicate that preoperative antibiotic prophylaxis should be used for periods less than 24 h in all noninfected patients undergoing prostate surgery. The cost of antibiotic therapy, presence of opportunistic organisms and the duration of hospital stay are reduced by antimicrobial prophylaxis.

Topics: Humans; Male; Netilmicin; Postoperative Complications; Premedication; Prostatic Diseases; Urinary Tract Infections

Twenty-two patients undergoing major head and neck surgery were included in a randomized trial to value the efficacy and side effects of parenteral short-term antibiotic prophylaxis of post-operative infections. Two different antibiotic regimens were compared: group A, ceftazidime i.v. (2 g) in three doses (half an hour before surgery, 8 and 16 hours, from the first dose); group B, netilmicin (100 mg) plus clindamycin (600 mg i.v.), following the same chronological schedule. Overall infection rate was 18% (4/22): all post-operative infections occurred in group A patients, including one case of wound infection and 3 mixed infections (wound infection associated with lung infection), with a significant reduction of post-operative infection rate in group B patients (p = 0.045; Fisher's exact test).

Topics: Adult; Aged; Aged, 80 and over; Bacterial Infections; Ceftazidime; Clindamycin; Drug Evaluation; Drug Therapy, Combination; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Netilmicin; Postoperative Complications; Premedication

We have conducted a multicentre randomized study to compare piperacillin with the combination of netilmicin and metronidazole in patients undergoing elective colorectal surgery. There was no significant difference in the incidence of operation-related infection, chest or urinary tract infection. Major life-threatening sepsis occurred in 6% and the overall incidence of operation-related infection was 24%. Organisms which normally inhabit the bowel lumen were cultured from most of the postoperative infections; however, Staphylococcus aureus was isolated as a causative organism in nine patients in the piperacillin group compared with none in the netilmicin and metronidazole group. We are concerned at the high incidence of infection in both groups, and we believe that other factors in addition to prophylactic antibiotics need to be evaluated if the incidence of infection is to be reduced further.

Topics: Adult; Aged; Bacterial Infections; Colon; Drug Therapy, Combination; Female; Humans; Male; Metronidazole; Middle Aged; Netilmicin; Piperacillin; Postoperative Complications; Premedication; Rectum; Surgical Wound Infection

In a randomized study the clinical and bacteriologic effectiveness of imipenem was compared with the classical combination of netilmicin with clindamycin in patients who had surgery for an intraperitoneal infection, localized or generalized, with positive bacteriologic findings of the specimen taken at surgery. Excluded were all patients who received other antibiotics before surgery, or who died within 3 days after antibiotic therapy was started. Imipenem was given at a dose of 500 mg t.i.d., clindamycin 600 mg t.i.d., and netilmicin according to serum levels. The diagnoses ranged from postoperative peritonitis, gallbladder empyema, perforated gastroduodenal ulcer, small bowel perforation with and without obstruction, and perforated appendicitis to perforation of the colon. The bacteriologic work-up included examination of the primary specimen (aerobic and anaerobic), the urine, feces, and serologic testing for Candida albicans once or twice a week and after the course of antibiotic therapy. In addition, pH measurements of abscesses and drainage fluids were performed. Ninety-three patients entered the study. Forty-seven patients were treated with imipenem (test group), and 46 patients were treated with the combination therapy (control group). The two groups did not show significant differences in age, sex, diagnostic groups, risk factors, primary bacteriology, and duration of therapy (mean: 6.7 days). Thirty-eight patients (80.9%) treated with imipenem were cured, six patients (12.8%) were improved, and there were three (6.4%) failures. The respective numbers for the control group were 31 (67.4%), 10 (21.7%), and 5 (10.9%). The mean duration of hospitalization was 19 days for the test group and 24.5 days for the control group. There were four wound infections in the test group and 11 wound infections in the control group. Imipenem is at least as effective in the adjuvant therapy of intra-abdominal infections as the combination of netilmicin with clindamycin.

Topics: Adolescent; Adult; Aged; Clindamycin; Clinical Trials as Topic; Drug Therapy, Combination; Female; Humans; Imipenem; Length of Stay; Male; Middle Aged; Netilmicin; Peritonitis; Postoperative Complications; Random Allocation; Reoperation; Surgical Wound Infection; Thienamycins

Transurethral resection of the prostate is associated with a major risk of postoperative infection. To evaluate the clinical and bacteriological efficacy of antibiotic prophylaxis with a single dose of netilmicin sulfate, we conducted a randomized study in 100 patients with sterile preoperative urine undergoing transurethral resection of the prostate. Of these patients 95 were evaluated: 47 were randomized to the control group and received an intramuscular injection of 1.5 ml. of a 0.9 per cent solution of sodium chloride 1 hour preoperatively and 48 were given an intramuscular injection of 150 mg. netilmicin sulfate in a volume of 1.5 ml. 1 hour preoperatively. Of the patients 16 in the control group (34 per cent) and only 1 in the treated group (2 per cent) had bacteriuria (greater than 10(5) bacteria per ml.) (p less than 0.001). This difference also was significant 2 and 5 days postoperatively (p less than 0.05 and p less than 0.001, respectively). One patient in the control group had bacteremia compared to none in the treated group. Clinical signs of infection were less common in the treated group. Sensitivity studies revealed that all of the organisms tested were sensitive to netilmicin sulfate. High concentrations of netilmicin sulfate were found in the urine collected at operation (162 +/- 112 micrograms per ml. urine).

Topics: Humans; Male; Netilmicin; Postoperative Complications; Premedication; Prostatectomy; Random Allocation; Urinary Tract Infections

In a prospective randomized double-blind study of 141 patients referred for reconstructive vascular surgery on the abdominal aorta and the lower extremities, placebo was compared to antibiotic prophylaxis. The prophylaxis group received three doses of a combination of methicillin, 2 g and netilmicin, 200 mg. Antibiotic prophylaxis reduced postoperative wound infections as compared to placebo, i.e. 4/69 (5.8%) vs. 12/72, (16.7%) respectively (P = 0.04). No graft infections occurred. Two cases of postoperative septicaemia were seen in the placebo group, none in the antibiotic group. Among different procedures aortic-femoral bypass operations showed the highest wound infection rates. The two treatment groups were comparable with regard to all other postoperative complications registered, including nephro- and ototoxicity. The antibiotic regimen was considered safe, but had only marginal value as prophylaxis in vascular reconstructive surgery on the abdominal aorta and the lower extremities.

Topics: Adolescent; Adult; Aged; Aorta, Abdominal; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Methicillin; Middle Aged; Netilmicin; Postoperative Complications; Premedication; Sepsis; Surgical Wound Infection; Vascular Surgical Procedures

The aim of this study was to compare the prophylactic effects of netilmicin plus metronidazole administered for one day and of doxycycline administered for five days on the incidence of postoperative sepsis in patients undergoing elective colorectal surgery. One hundred patients were studied, 50 men and 50 women, with a mean age of 66.6 years. The patients were randomized into the two groups. Wound infections occurred in a total of 9 patients, 5 in the doxycycline group and 4 in the group given netilmicin plus metronidazole, i.e. the overall infection rate was 9%. It is concluded that there is no statistically significant difference on the incidence of postoperative wound sepsis in patients undergoing elective colorectal surgery between the group given doxycycline for five days and the group given netilmicin plus metronidazole for one day.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Colon; Doxycycline; Female; Humans; Male; Metronidazole; Middle Aged; Netilmicin; Postoperative Complications; Rectum; Sepsis; Surgical Wound Infection

We studied for one year 60 patients separated in 3 groups of 20: first reference group without treatment; second group receiving netilmicin in premedication; third group treated by netilmicin for 2 days postoperatively. This series clearly demonstrates the high urinary tract infection rate after transurethral surgery, the benefit of antibioprophylaxis with netilmicin and the efficiency of one dose of this aminosid given one hour preoperatively.

Topics: Aged; Clinical Trials as Topic; Female; Follow-Up Studies; Humans; Male; Middle Aged; Netilmicin; Polyps; Postoperative Complications; Prostatectomy; Urethra; Urinary Bladder Neoplasms; Urinary Tract; Urinary Tract Infections

In an effort to reduce infection rates in elective colorectal surgery to acceptable levels without oral non-absorbable antimicrobials, using only a short course of systemic antimicrobials, 50 patients were studied in a multicentre trial. Each patient received metronidazole for anti-anaerobic coverage. The anti-aerobic coverage consisted of netilmicin, cefuroxime or placebo, administered in a double-blind manner. Five out of 36 evaluable patients had an infection at the operation site. Two patients had peritonitis (one metronidazole-netilmicin and one metronidazole-placebo) and three had a wound abscess in the abdominal wall (all metronidazole-placebo). It is concluded that a short course of peroperative systemic prophylaxis with metronidazole and netilmicin or cefuroxime--without the use of oral non-absorbable antimicrobials--gave acceptable results in the centres studied.

Topics: Cefuroxime; Cephalosporins; Clinical Trials as Topic; Colon; Double-Blind Method; Drug Evaluation; Drug Therapy, Combination; Humans; Injections, Intravenous; Metronidazole; Netilmicin; Postoperative Complications; Premedication; Random Allocation; Rectum; Wound Infection

Infection can be a devastating complication after implantation of a cortical bone allograft. The allograft could act as a vehicle for local antibiotic prophylaxis.. We studied the release of antibiotics in vitro from cortical bone allografts impregnated with antibiotics for different periods of time. We also studied whether cortical allografts impregnated with antibiotics could eradicate Staphylococcus aureus from an experimentally infected graft in vivo. In the in vitro study, pieces of cortical bone were impregnated with netilmicin, vancomycin, ciprofloxacin and rifampicin for 1 h, 10 h and 100 h. The antibiotics were eluted into phosphate-buffered saline (PBS) for 7 days, with daily transfer of the bone into fresh PBS. In the in vivo study, cortical allografts impregnated with antibiotics were placed in rats intramuscularly. 10 microL of an S. aureus suspension (0.6 x 10(5) CFU) was placed in the intramedullary cavity. After 15 days, the allografts were removed and examined for bacterial growth.. The amount of antibiotics released in vitro was influenced by the time used for antibiotic impregnation of the bone. Allografts impregnated with netilmicin, vancomycin and rifampicin effectively eradicated perioperative contamination with S. aureus in vivo.. This study shows that a cortical bone allograft would be an effective vehicle for local antibiotic delivery.

Topics: Animals; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bone Transplantation; Femur; Netilmicin; Postoperative Complications; Rats; Rats, Wistar; Rifampin; Staphylococcal Infections; Staphylococcus aureus; Transplantation, Homologous; Vancomycin

Wound infection and secondary meningitis are important complications for patients undergoing acoustic neuroma surgery. The Authors retrospectively evaluated the efficacy of a short-term protocol utilizing vancomycin and netilmicin. 434 patients underwent acoustic neuroma surgery in the Otorhinolaryngology Division, A.O. Ospedali Riuniti di Bergamo, from February 1987 to February 1997. Perioperative short-term prophylaxis was administered with vancomycin plus netilmicin. The utility of the prophylaxis schedule was evaluated on the basis of the occurrence of infectious episodes during the first 10-day follow-up. Only 2 episodes (0.5%) of bacterial meningitis were observed.

Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Female; Gentamicins; Humans; Male; Meningitis, Bacterial; Netilmicin; Neuroma, Acoustic; Postoperative Complications; Retrospective Studies; Surgical Wound Infection; Vancomycin

Thrombotic obstruction is rare in bacterial endocarditis involving prosthetic heart valves. A 45-year-old man who had three intracardiac, ball-cage-type prosthetic valves, presented with streptococcal septicemia. Major obstruction of the tricuspid Smeloff-Cutter valve and normal function of the two other prostheses were documented by Doppler echocardiography. Emergency replacement of the tricuspid valve alone was decided on the one basis of this echocardiographic diagnosis, and successfully performed. Operative findings confirmed the noninvasive findings.

Topics: Ampicillin; Aortic Valve; Bioprosthesis; Combined Modality Therapy; Echocardiography, Doppler; Endocarditis, Bacterial; Heart Valve Prosthesis; Humans; Male; Middle Aged; Mitral Valve; Netilmicin; Postoperative Complications; Prosthesis Design; Prosthesis Failure; Rheumatic Heart Disease; Streptococcal Infections; Tricuspid Valve

Thirteen episodes of fever in bone marrow transplantation recipients (23 months to 11 years old children) were treated by ceftazidime (100-200 mg/kg/j) and netilmicin (7 mg/kg/j). Vancomycin was added at the 24th hour in 10 cases of persistent fever. 6 presumed agents of infection were isolated before antibiotic treatment: blood cultures (streptococci 2, staphylococcus 1, proteus 1), fecal sample (E. coli 1), urine (E. coli 1). Modifications of aerobic fecal flora were studied under this treatment. E. coli, staphylococci and enterococci were the mainly strains isolated. There were no third generation cephalosporins resistant Gram-negative bacteria. High level resistance to aminoglycosides was observed in enterococcal strains, isolated during and after treatment. Ceftazidime-netilmicin (+/- vancomycin) was an effective and safe combination for the management of febrile neutropenic episodes.

Topics: Bacteria; Bacterial Infections; Bone Marrow Transplantation; Ceftazidime; Child; Child, Preschool; Drug Evaluation; Drug Therapy, Combination; Female; Humans; Male; Microbial Sensitivity Tests; Netilmicin; Postoperative Complications; Sepsis; Time Factors; Vancomycin

Basic glutathione transferase released from the proximal tubular epithelium in the kidney was monitored in the urine of 69 recipients of renal allografts. The enzyme was isolated from human liver and the urinary analysis performed with radioimmunoassay. Patients receiving cyclosporine A without toxicity or rejection did not excrete this enzyme in their urine; whereas the urine of patients with cyclosporine A-induced nephrotoxicity contained significant amounts of the transferase (P less than 0.001). Patients with allograft rejection also showed increased urinary concentrations of the basic glutathione transferase, but had significantly lower values than patients with cyclosporine induced nephrotoxicity (P less than 0.001). During aminoglycoside and co-trimoxazole treatment, the urinary concentration of this transferase also increased. Patients with renal infarction showed a sudden increase in urinary transferase to very high levels. The results indicate that quantitative analysis of the basic glutathione transferase in urine is useful for monitoring renal tubular lesions present in various complications following transplantation, such as cyclosporine and antibiotic induced nephrotoxicity and renal infarction.

Topics: Adolescent; Adult; Aged; Child; Clinical Enzyme Tests; Cyclosporins; Drug Combinations; Drug Therapy, Combination; Female; Glutathione Transferase; Graft Rejection; Humans; Kidney Diseases; Kidney Transplantation; Male; Middle Aged; Netilmicin; Postoperative Complications; Radioimmunoassay; Sulfamethoxazole; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination

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

Seventy-seven elective or emergency surgical patients were treated with a prophylactic course of netilmicin. Netilmicin (150 mg intramuscularly) was given 1 hour prior to operation and continued 12 hourly until the patient was free of risk of post-operative infection. There was no microbiological or clinical evidence of post-operative infection in general surgical or orthopaedic patients. Netilmicin seems to be less nephrotoxic than other aminoglycosides. Netilmicin serum levels were within expected values. Netilmicin was found to be an effective and well-tolerated antibiotic, and prophylactic treatment shortened the mean patient bed-stay and hence costs incurred.

Topics: Adult; Aged; Female; Gentamicins; Humans; Kidney; Kidney Failure, Chronic; Male; Middle Aged; Netilmicin; Postoperative Complications; Wound Infection

In the present study, we used netilmicin for the postoperative complications and obtained the following results. 1. Netilmicin was used in totally 29 cases; 23 with localized peritonitis, 4 with generalized peritonetis and 2 with wound infection. Excellent effects were obtained in 2 cases, effective results in 24 cases and ineffective results in 3 cases. The effective rate was 89.7%. 2. Adverse reactions or abnormal clinical laboratory test results which might be attributable to the use of netilmicin were not noticed.

Topics: Adult; Aged; Child; Drug Evaluation; Female; Gentamicins; Humans; Male; Middle Aged; Netilmicin; Peritonitis; Postoperative Complications; Surgical Wound Infection