Netilmicin

These indications are based on manufacturer information for both originator and generic products. For product specific registered indications, please refer to product specific manufacturer information

Registered South African indications:

• Serious or life-threatening infections caused by susceptible strains of: Escherichia coli, Klebsiella-Enterobacter-Serratia sp., Citrobacter sp., Proteus sp. (indole-positive and indole-negative), Pseudomonas aeruginosa and Staphylococcus sp. (coagulase-positive and coagulase-negative, including penicillin- and methicillin-resistant strains)
• Acute, uncomplicated gonococcal infection in the male (urethra, rectum) and female (urethra, cervix, rectum) with normal renal function 

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Hypersensitivity to aminoglycosides
• Pregnancy

Cautions

• Breastfeeding
• Renal impairment
• Hepatic impairment
• Elderly
• Extensive body surface burns
• Myasthenia gravis
• Parkinsonism
• Infant botulism
• Dehydration

Forms avail. in SA and covered in this monograph: inj

Infections caused by: Most Gram-negative organisms and some Gram-positive organisms (including Staphylococcus spp.)

General dosing range

• IM/IV: 4-7.5mg/kg/day, in 2-3 divided doses; Treatment durations: 7-14 days

Specific doses based on individual indications

Please note that the dosages below should be used in combination with regional guidelines, taking into account local antibiotic sensitivities

Systemic and urinary tract infections

• IM/IV: 4-6mg/kg/day, in 2-3 divided doses; Treatment duration: 7-14 days (Manufacturer recommendation)

Severe life threatening infections

• IM/IV: 7.5mg/kg/day, in 3 divided doses (Manufacturer recommendation)

Dosage should be reduced to 6mg/kg/day as soon as clinically indicated, usually within  48hrs

Infuse solution over 30-120min

Paed. forms avail. in SA and covered in this monograph: inj

Infections caused by: Most Gram-negative organisms and some Gram-positive organisms (including Staphylococcus spp.)

General dosing range

Younger than 1 week

• IM/IV: 6mg/kg/day, in 2 divided doses; Treatment duration: 7-14 days (Manufacturer recommendation)

Between 1 week - 1 year

• IM/IV: 7.5-9mg/kg/day, in 3 divided doses; Treatment duration: 7-14 days (Manufacturer recommendation)

Older than 1 year

• IM/IV: 6-7.5mg/kg/day, in 3 divided doses; Treatment duration: 7-14 days (Manufacturer recommendation)

Infuse solution over 30-120min

Pregnancy

• Contraindicated

Breastfeeding

• Caution

Renal Impairment

• Caution; dose adjustment recommended

Hepatic Impairment

• Caution; no information available

Elderly

• Caution; no dose adjustment recommended

Central Nervous System Disorders

• Neurotoxicity
• Eighth cranial nerve toxicity
• Dizziness
• Vertigo
• Malaise
• Disorientation
• Paraesthesia

Cardiovascular Disorders

• Tachycardia
• Hypotension
• Palpitations

Gastrointestinal Disorders

• Vomiting
• Diarrhoea

Hepatobiliary Disorders

• Increased bilirubin

Genitourinary Disorders

• Nephrotoxicity
• Fanconi-like syndrome

Endocrine and Metabolic Disorders

• Increased blood sugar
• Increased alkaline phosphatase
• Increased potassium

Skin and Subcutaneous Tissue Disorders

• Rash
• Fluid retention
• Injection site reaction

Immune, Blood and Lymphatic System Disorders

• Thrombocytosis
• Chills
• Anaphylaxis
• Fever
• Anaemia
• Leucopaenia
• Thrombocytopaenia
• Eosinophilia
• Increased prothrombin time

Sensory Disorders

• Tinnitus
• Roaring in the ears
• Hearing loss
• Visual disturbance

• Carbenicillin
• Amphotericin B
• Cisplatin
• Cyclosporine
• Neuromuscular blocking agents
• Loop diuretics 
• Non-polarizing muscle relaxants 
• Radiographic contrast 
• Non-steroidal anti-inflammatory drugs
• Vancomycin

• Renal function

Specific cases may require

• Audiometry
• Vestibular function

Netilmicin sulphate is a semi-synthetic, water-soluble antibiotic of the aminoglycoside group. It is a rapidly acting bactericidal antibiotic which probably acts by inhibiting normal protein synthesis in susceptible organisms.

Spectrum of activity: Most Gram-negative organisms and some Gram-positive organisms (including Staphylococcus spp.) 

Injection (per ml) 100mg

• Netromycin (Schering-Plough) originator