Netilmicin use in pediatric patients.

40 newborn infants and children were treated with netilmicin. With a 2-mg/kg dose, the average peak serum concentration was 4.4 microgram/ml. Serum concentrations resulting from the first dose were markedly lower than subsequent doses and therapeutically inadequate. Significant drug accumulation did not occur: peak and trough concentrations on days 2 and 7 were the same in patients with normal renal function. The half-life of netilmicin in infants less than 1 week old was 3.8 h in infants older than 1 week. Infants less than 7 days old require a prolonged dose interval (12 h) to adequately clear the administered dose. Recovery of netilmicin in urine ranged from 50 to 100% and correlated with age and duration of treatment. Elimination of netilmicin was prolonged in newborn infants with renal failure and requires dosage adjustment. Transient change in creatinine clearance occurred in 2 patients (4.6%) and ototoxicity was observed on 2 other patients.