Campoli-Richards D M, Chaplin S, Sayce R H, Goa K L
ADIS Drug Information Services, Auckland, New Zealand.
Drugs. 1989 Nov;38(5):703-56. doi: 10.2165/00003495-198938050-00003.
Netilmicin is a semisynthetic aminoglycoside derived from sisomicin. It is active against most Gram-negative and some Gram-positive bacteria, including many gentamicin-resistant strains. Netilmicin has proved to be effective in Gram-negative infections of the urinary tract, skin and skin structure, and lower respiratory tract, as well as in intra-abdominal infections, septicaemia and other miscellaneous infections. In some trials, the more easily implemented once daily administration of netilmicin has been as effective as multiple dosing regimens. However, further investigation is required to confirm that efficacy and safety are not compromised with once daily administration. Comparative studies have generally revealed similar clinical and bacteriological efficacies between netilmicin and gentamicin, amikacin or tobramycin. As with other aminoglycosides, the principal adverse effects of netilmicin are nephrotoxicity and ototoxicity. Although animal studies strongly suggest that these are less common with netilmicin than with related drugs, there appears to be no difference in their incidence in clinical use; in clinical trials the incidence of nephrotoxicity and ototoxicity has been low, with the symptoms in many cases being minor and reversible. Netilmicin is, therefore, an effective antibacterial drug for the parenteral treatment of severe infections, offering theoretical advantages in safety which may indicate its use for patients believed to be at risk of adverse effects.
奈替米星是一种由西索米星半合成的氨基糖苷类抗生素。它对大多数革兰氏阴性菌和一些革兰氏阳性菌有效，包括许多耐庆大霉素的菌株。奈替米星已被证明对尿路感染、皮肤及皮肤结构感染、下呼吸道感染有效，也可用于腹腔内感染、败血症及其他杂类感染。在一些试验中，奈替米星更易于实施的每日一次给药方案与多次给药方案效果相当。然而，需要进一步研究以确认每日一次给药不会影响疗效和安全性。比较研究通常显示奈替米星与庆大霉素、阿米卡星或妥布霉素之间具有相似的临床和细菌学疗效。与其他氨基糖苷类抗生素一样，奈替米星的主要不良反应是肾毒性和耳毒性。虽然动物研究强烈表明奈替米星引起这些不良反应的情况比相关药物少见，但在临床应用中其发生率似乎并无差异；在临床试验中，肾毒性和耳毒性的发生率较低，许多情况下症状轻微且可逆转。因此，奈替米星是用于严重感染肠外治疗的一种有效抗菌药物，在安全性方面具有理论优势，这可能表明它适用于被认为有不良反应风险的患者。
