Research Journal of Pharmaceutical Dosage Form and Technology

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Pharmacoepidemiology of Severe Systemic Infection and Need of Netilmicin Monotherapy or Combination Therapy:Systemic Review and Meta- Analysis


Affiliations
1 Surgycare Lifescience, Sendhwa (MP), India
2 SND College of Pharmacy, Yeola (MS), India
3 RD Memorial Ayurvedic College, Bhopal (MP), India
     

   Subscribe/Renew Journal


In this systematic review and meta-analysis we compared the efficacy and safety in patient with severe systemic infection (SSF) who has been either on netilmicin (NL) monotherapy or combination of netilmicin with other antibiotics (NLC). A systematic review of the literature was performed in accordance with PRISMA guidelines in Medline and Embase. A comprehensive search was performed from 1978 to 2017. Total 17 studies were identified that include 976 randomized patients with SSF. 489 patients enrolled in 11 studies for NL while 487 in NLC group. The meta-analysis showed that there was a statistically significant difference in rate of clinical efficacy (rate of failure) between NL (13.09%) and comparator NLC (20.91%). Nephrotoxicity associated with the therapy showed minor difference between both group, NL (13.80%) and NLC (10.09%). The study was further compare on the basis of dose regimen viz once a day (OD) and three times a day (TID). 184 patients of 4 studies received once in a day netilmicin monotherapy (OD-NL) while 259 patients of 7 studies received three times a day netilmicin monotherapy (TID-NL).Result of dose regimen group showed 11.04% rate of failure and 11.78% incidence of nephrotoxicity in (OD-NL) and 12.5% and 13.84% respectively in (TID-NL).The paucity of data from this evidence based systematic review and meta-analysis, favors NL monotherapy, if the slightly more chances of nephrotoxicity than comparator NLC neglected.

Keywords

Netilmicin, Sever Infection, Netilmicin Combination Therapy, Nephrotoxicity, Meta Analysis.
Subscription Login to verify subscription
User
Notifications
Font Size


  • Matthieu L, Adeline M, Benoit S et al. The strategy of antibiotic use in critically ill neutropenic patients. Ann Intensive Care. 2012; 2:1-9.

  • Kibe S, Adams K, Barlow G et al. Diagnostic and prognostic biomarkers of sepsis in critical care. J Antimicrob Chemother. 2011; 66:33-40.

  • Chesney RW, McCarren DM, Haddad JG, et al. Pathogenic mechanisms of the hypocalcaemia of the staphylococcal toxic shock syndrome. J Lab Clin Med. 1983; 101:576-85.

  • Charles VP. Current status of combined antibiotic therapy. J Pediatrics. 1958; 21:1000-09

  • Tamma PD, Cosgrove SE, Maragakis LL. Combination therapy for treatment of infections with gram-negative bacteria. Clin Microbiol Rev. 2012; 25:450–70.

  • Lubos D, Giampaolo B, Thierry C et al. The need for aminoglycosides in combination with β-lactams for high-risk, febrile neutropaenic patients with leukaemia. Eu J Canc Supp. 2007; 5:13-22

  • Turnidge J. Pharmacodynamics and dosing of aminoglycosides. Infect Dis Clin N Am. 2003; 17:503-28.

  • Dana Maglio, Extended interval aminoglycoside dosing: from concept to clinic. Int J Antimicrob Agents. 2002; 19:341-8.

  • Kim Ming Wong, Chan YH, Cheung CY et al. Cefepime versus vancomycin plus netilmicin therapy for continuous ambulatory peritoneal dialysis associated peritonitis. Am J Kidney Dis. 2001;38: 127-31

  • Endre L et al. Efficacy and safety of ceftriaxone plus netilmicin once daily versus ceftazidime plus netilmicin twice daily in severe nosocomial infections. Cur Therap Research. 1993; 53:687-92.

  • Perazella MA. Toxic Nephropathies: Core Curriculum 2010. Am J Kidney Dis. 2010; 55:399-09.

  • Broe ME, Giuliano RA, Verpooten GA. Choice of drug and dosage regimen. Two important risk factors for aminoglycoside nephrotoxicity. Am J Med. 1986; 80:115-8.

  • Gonzalez US, Spencer JP. Aminoglycosides: a practical review. Am Fam Physician. 1998; 58:1811-20.

  • Richard A, Krieger JN. Gentamicin for the practicing urologist: review of efficacy, single daily dosing and "switch" therapy. J Urology. 2000; 163: 1076-84

  • Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009; 6:1000-10.

  • DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials.1986; 7: 177–88.

  • Alessandra V Nicolia P, Luca B et al. Comparison of 5 Milligrams of netilmicin per kilogram of body weight once daily versus 2 milligrams per kilogram thrice daily for treatment of gramnegative pyelonephritis in children, J Antimicrob agents and chemother. 1992; 36: 1499-03

  • Auwera P, Meunier F, Ibrahim S et al. Pharmacodynamic parameters and toxicity of netilmicin (6Milligrams/Kilogram/Day) given once daily or in three divided doses to cancer patients with urinary tract infection. J Antimicrob agents and chemother. 1991; 35: 640-7.

  • Prat V, Horcicková M, Hatala M et al. Long-term effect of the administration of repeated single doses of netilmicin in urinary tract infections, Cas Lek Cesk. 1990;129:306-8.

  • Donald K, Irwin T, James P et al. Pharmacology and efficacy of netilmicin. J Antimicrob agents and chemother. 1978; 13: 832-6.

  • Richard DM, Bonnie VB, Paul HE et al. Prospective comparative study of efficacy and toxicity of netilmicin and amikacin. J Antimicrob agents and chemother. 1980; 17:217-25.

  • Michael B, Michael WL, Francis PT et al. Prospective randomized trial of netilmicin and amikacin, with emphasis on eighth nerve toxicity. J Antimicrob agents and chemother. 1980; 17:707-14.

  • Tange RA, Dreschler WA, Prins JM et al. Ototoxicity and nephrotoxicity of gentamicin vs netilmicin in patients with serious infections. A randomized clinical trial. Clin Otolaryngol Allied Sci. 1995; 20:118-23.

  • Hellum KB, Madsen ST, Digranes A et al. High dose netilmicin therapy of severe or chronic infections. Scand J Infect Dis Suppl. 1980; 23:189-94.

  • Perera MR, Amirak ID, Noone P. Netilmicin 200 mg twice a day for adult patients with life-threatening infections. A preliminary report. Scand J Infect Dis Suppl. 1980; 23:186-8.

  • Jahre JA, Fu KP , Neu HC. Clinical evaluation of netilmicin therapy in serious infections. AM J Med 1979; 66:67-73.

  • Zhao CA, Li J, Hou J, Guo M et al. Randomized controlled clinical trial on etimicin, a new aminoglycoside antibiotic, versus netilmicin in the treatment of bacterial infections. J Chin Med. 2000; 113:1026-30.

  • Cometta A, Baumgartner JD, Lew D et al. Prospective randomized comparison of imipenem monotherapy with imipenem plus netilmicin for treatment of severe infections in nonneutropenic patientst. J Antimicrob agents and chemother. 1994; 38: 1309-13.

  • CHEK CC, Beryl AP, Heather A et al. Randomized trial comparing ciprofloxacin plus netilmicin versus piperacillin plus netilmicin for empiric treatment of fever in neutropenic patients. J Antimicrob agents and chemother. 1989; 33: 87-91.

  • Nasu M, Goto Y, Yamasaki T et al. Clinical studies on the time-difference combination therapy with netilmicin and minocycline in methicillin resistant staphylococcus aureus infections Jpn J Antibiot. 1994; 47:1305-17.

  • Hoffken G, Pasold R, Pfluger KH et al. An open, randomized, multicentre study comparing the use of low-dose ceftazidime or cefotaxime, both in combination with netilmicin, in febrile neutropenic patients J Antimicr Chemo. 1999; 44: 367–76.

  • Bubrick MP, Howard RJ , Pancorbo S et al. A comparative study of netilmicin-cefoxitin and gentamicin-cefoxitin in surgical patients with serious systemic infection. Clin Therapeutics. 1983; 5:515-24.

  • Kahalley S, Chandler J , Hawkins J et al. Prospective, randomized comparison of the efficacy and safety of netilmicin-clindamycin and tobramycin-clindamycin in the treatment of serious systemic infections. Clin Therapeutics. 1985; 7:497-06.


Abstract Views: 213

PDF Views: 0




  • Pharmacoepidemiology of Severe Systemic Infection and Need of Netilmicin Monotherapy or Combination Therapy:Systemic Review and Meta- Analysis

Abstract Views: 213  |  PDF Views: 0

Authors

Akhilesh Gupta
Surgycare Lifescience, Sendhwa (MP), India
Swati Rawat
SND College of Pharmacy, Yeola (MS), India
Prabhanshu Gupta
RD Memorial Ayurvedic College, Bhopal (MP), India

Abstract


In this systematic review and meta-analysis we compared the efficacy and safety in patient with severe systemic infection (SSF) who has been either on netilmicin (NL) monotherapy or combination of netilmicin with other antibiotics (NLC). A systematic review of the literature was performed in accordance with PRISMA guidelines in Medline and Embase. A comprehensive search was performed from 1978 to 2017. Total 17 studies were identified that include 976 randomized patients with SSF. 489 patients enrolled in 11 studies for NL while 487 in NLC group. The meta-analysis showed that there was a statistically significant difference in rate of clinical efficacy (rate of failure) between NL (13.09%) and comparator NLC (20.91%). Nephrotoxicity associated with the therapy showed minor difference between both group, NL (13.80%) and NLC (10.09%). The study was further compare on the basis of dose regimen viz once a day (OD) and three times a day (TID). 184 patients of 4 studies received once in a day netilmicin monotherapy (OD-NL) while 259 patients of 7 studies received three times a day netilmicin monotherapy (TID-NL).Result of dose regimen group showed 11.04% rate of failure and 11.78% incidence of nephrotoxicity in (OD-NL) and 12.5% and 13.84% respectively in (TID-NL).The paucity of data from this evidence based systematic review and meta-analysis, favors NL monotherapy, if the slightly more chances of nephrotoxicity than comparator NLC neglected.

Keywords


Netilmicin, Sever Infection, Netilmicin Combination Therapy, Nephrotoxicity, Meta Analysis.

References