Netilmicin versus tobramycin in multi-centre studies

Abstract

In two prospective, randomized studies conducted in West Germany and involving 80 patients, netilmicin-ticarcillin was compared to tobramycin-ticarcillin in the treatment of serious systemic infections. Both regimens were essentially identical with respect to the clinical and bacteriological results they produced. The netilmicin group developed significantly less nephrotoxicity than the tobramycin group (0% versus 15%, P = 0.03). Ototoxicity also occurred less frequently in the netilmicin-treated patients (3% versus 10%, P = 0.4). In a large collaborative study involving 15 centres, 254 patients were enrolled. Clinical and bacteriological responses were excellent, with netilmicin and tobramycin equally effective, but the incidences of nephrotoxicity and ototoxicity were lower in patients treated with netilmicin than those receiving tobramycin.

Discovery and development of new antimicrobial agents

“…The development of new aminoglycosides followed a pattern aimed at identifying SAR that blocked susceptible sites for enzymatic modification on the molecule while retaining the acceptable safety profile of the earlier agents (9,17). While many new analogs were tested clinically (33,126,138), amikacin remains one of the most useful due to the relatively infrequent occurrence of resistance encountered (13,107). Amikacin use was often restricted in many hospitals in hopes of preventing the emergence of resistant strains, but its use for empiric therapy in combination with beta-lactams has been widely adopted in centers where resistance to the older aminoglycosides is common.…”

Tobramycin Promotes Melanogenesis by Upregulating p38 MAPK Protein Phosphorylation in B16F10 Melanoma Cells

“…However, tobramycin exhibits side effects such as kidney damage, hearing damage, and serious allergic reactions [15,20,21,22]. Over time, its use has gradually decreased due to the emergence of antibiotic-resistant bacteria and the development of more effective antibiotics [23,24,25]. Therefore, we initiated the current study to identify other possible clinical uses of tobramycin.…”

Antibiotics: a clinical update

“…Netilmycin is the newest agent and is as effective as other aminoglycosides but is less toxic 10 , 11 , although the use of dosage nomograms and the careful monitoring of serum levels is essential to ensure minimum effects of toxicity and the maximum therapeutic benefit.…”