新アミノ配糖体系抗生剤Netilmicinに関する基礎的・臨床的研究

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  • LABORATORY AND CLINICAL STUDIES ON NETILMICIN, A NEW AMINOGLYCOSIDE ANTIBIOTIC
  • シン アミノ ハイトウ タイケイ コウセイザイ Netilmicin ニ カン

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Laboratory and clinical studies were carried out on Netilmicin, a newly developed aminoglycoside antibiotic which is a derivative of Sisomicin.<BR>Netilmicin was compared with Gentamicin (GM) for antibacterial activity against 378 routine clinical isolates. Netilmicin was found to be similar in activity to GM against Escherichia coli, Klebsiella aerogenes, Enterobacter cloacae, E. aerogenes, Proteus vulgaris and P. morganii. Against Serratia marcescens, P. mirabilis, P. rettgeri and Pseudomonas aeruginosa, Netilmicin was slightly less active than GM.<BR>Netilmicin was injected intramuscularly to two patients with chronic urinary tract infection due to S. marcescens. Both patients had an indwelling catheter. The peak serum concentrations were 17μg/ml and 23.6 μg/ml after administration of 75 mg and 100 mg, respectively.<BR>Netilmicin was excreted into the urine at the concentration of 100-200μg/ml and minimum inhibitory concentration (MIC) of Netilmicin against S. marcescens isolated was 3.13-6. 25μg/ml. Viable count of S. marcescens in the urine was stable during the study for 6-9 hours after injection.<BR>Netilmicin was administered during two separate periods to a patient with chronic bronchitis due to Haemophilus influenzae at the doses of 100 mg and later 200 mg. The peak serum levels after injection of 100 mg and 200 mg were 16.6μg/ml and 19.0μg/ml, respectively. The peak sputum level was around 4μg/ml for both dosages. Haemophilus influenzae in the sputum after intramuscular injection of 200 mg was reduced from 107-8/ml at the beginning, to around 103/ml 5-6 hours afterwards.<BR>Netimicin was given to a total of 16 patients with respiratory and urinary infections. Six out of them responded effectivly to the treatment with efficacy rate of 42.8%. Such a poor clinical result is considered to be attributable to the fact that a majority of patients had severe underlying diseases.<BR>Four out of 18 cases injected had the following adverse reaction, i. e. numbness in the lips, numbness in the face, feeling of vertigo and transient elevation of S-GOT accompanied with that of alkaline phosphatase.

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