依替米星与奈替米星对照治疗细菌性感染的评价

目的：比较依替米星与奈替米星治疗细菌性感染的安全性及有效性。方法：采用随机对照平行开放的试验方法，治疗呼吸道感染、泌尿道感染、皮肤软组织感染患者65例。34例患者采用依替米星治疗，3l例患者采用奈替米星(均为100mg，每12h静脉注射)治疗，疗程7-10d。结果：两组临床有效率分别为依替米星组85.3％，奈替米星组83．9％，细菌清除率分别为87.5％和89．7％，不良反应发生率分别为8.6％与9．4％。结论：依替米星与奈替米星治疗呼吸道感染、泌尿道感染、皮肤软组织感染安全，有效，两组结果差异无显著性(P＞0.05)。     

奈替米星治疗肺部感染的疗效观察

目的观察奈替米星治疗肺部感染的临床疗效及其不良反应。方法89例确诊为肺部感染的住院急者给予奈替米星300mg加入5％葡萄糖溶液或0．9％生理盐水溶液500ml中静脉滴注,1次／d,连续7—14d。结果临床疗效总有效率为75．9％;对各种致病菌感染细菌学疗效总有效率为79．5％;对各种致病菌感染细菌清除率为77．3％。不良反应发生率为4．5％。结论奈替米星是一种值得推广应用的新氯基糖甙类抗生素。     

国产奈替米星临床与实验室研究

采用国产奈替米星和阿米卡星随机对照治疗各种类型急性细菌性感染２０４例，奈替米星７７例与阿米卡星７６例作随机对照，开放试验５１例。治愈率和有效率分别为７５．３％，９６．１％；６７．１％、９３．４％、８６．３％，９４．１％（Ｐ〉０．１，Ｐ〉０．２５），细菌清除率分别为９０．７；８８．０％；９３．０％（Ｐ〉０．０５），不良反应发生率分别为５．１％、３．９％、３．９％（Ｐ〉０．５），试验组和对照组临床疗效     

杭州市级医院院内感染291株病原菌耐药性分析

目的：为临床合理使用抗生素提供可靠依据。方法：将杭州市6家综合性医院于2002年上半年从临床分离出的291株细菌对16种抗生素的耐药性进行分析。结果：万古霉素对革兰氏阳性细菌敏感率为100％；金黄色葡萄球菌、表皮葡萄球菌对青霉素、苯唑西林、氨苄西林／舒巴坦、庆大霉素、奈替米星、培氟沙星的耐药率为81．5％～100％；亚胺培南对革兰氏阴性细菌敏感率最高(87．7％)。其次为丁胺卡那、氨曲南、头孢他啶、妥布霉素、头孢曲松、奈替米星，分别为68．3％，64．6％，63.5％，58.2％，55．6％，51．6％，但铜绿假单胞茵对亚胺培南的耐药率很高(31.5％)。结论：开展医院内感染病原菌对常用广谱抗生素的耐药性监测，对指导临床合理用药、延缓细菌耐药性产生有重要意义。     

奈替米星治疗下呼吸道感染41例

目的：了解奈替米星治疗下呼吸道感染的临床疗效。方法：41例下呼吸道感染患者为治疗组（奈替米星200mg.d^-1静脉滴注）,与同期同类30例住院患者作对照（青霉素800万u.D^-1加氨苄西林8．0g.d^-1,静脉滴注）,结果：28．9％,总有效率97．6％。结论：奈替米星治疗下呼吸道感染疗效好,不良反应小,疗程短。     

奈替米星治疗肺部感染的疗效观察

目的:观察奈替米星治疗肺部感染的临床疗效及其副反应。方法:89例确诊为肺部感染的住院患者给予奈替米星300mg加入5％葡萄糖溶液或0.9％生理盐水溶液500ml中静脉滴注,每日1次,连续7～14天。结果:临床疗效总有效率为75.9％;对各种致病菌感染细菌学疗效总有效率为79.5％;对各种致病菌感染细菌清除率为77.3％。不良反应发生率为4.5％。结论:奈替米星是一种值得推广应用的新氨基糖甙类抗生素。     

依替米星与奈替米星随机对照治疗细菌性感染多中心临床试验

以多中心临床试验以奈替米星为对照药,采用随机对照平行开放的试验方法,目的是评价国产依替米星治疗临床常见细菌性感染的安全有效性。奈替米星与依替米星剂量均为100mg,每12h静脉注射,疗程7－10d。本项临床试验共入选病例243例,其中入选依替米星组122例,临床疗效评价病例103例,安全性评价例数106例,入选奈替米星组121例,临床疗效评价病例101例,安全性评价病例102例。试验治疗结果如下：两组总有效率分别为87.4%和87.1%,治疗各种致病菌感染临床有效率分别为86.7%和87.6%,细菌清除率分别为89.9%和89.7%,药物不良反应发生率分别为8.5%与8.8%。结果表明,依替米星与奈替米星治疗临床常见急性细菌性感染安全、有效,两组结果无统计学显著性差异（P＞0.05)。     

硫酸奈替米星与阿米卡星治疗重症监护病房中肺部感染的疗效比较

将重症监护病房１１９例继发肺部感染病人随机分成两组，分别给予硫酸奈替米星３００ｍｇ／ｄ或阿米卡星６００ｍｇ／ｄ治疗，根据临床表现、白细胞计数、痰培养、胸片及肝肾功能等其它辅助检查，观察其疗效及不良反应。结果显示：硫酸奈替米星有效率（７９．７％）比阿米卡星（５７．８％）高；辅助检查中白细胞计数、胸片恢复正常率和痰培养转阴率前组均高于后组，而不良反应前组低于后组。本文认为：对重症监护病房肺部感染初期，痰培养及药敏尚未确定的病人，给予硫酸奈替米星３００ｍｇ／ｄ短程治疗是有效且安全的方案，尤其对老年人、小儿和有轻度肾功能损害者，在严密肾功能监护下，可有针对性使用，故硫酸奈替米星具有较大的临床使用价值     

国产硫酸奈替米星注射剂疗效与安全性评价

目的 评价国产硫酸奈替米星注射剂的疗效与安全性. 方法 采用自制调查表对应用过国产硫酸奈替米星注射剂的住院患者疗效和安全性进行回顾性调查和统计分析. 结果 使用过国产硫酸奈替米星注射剂及联合其他抗菌药物治疗感染的病例71例,其中15例单独使用. 均采用静脉滴注的给药方式. 用药剂量为0.1～0.4 g,qd或bid, 溶媒量100～250 mL,平均用药天数（8.09 ±4.95） d. 治疗感染总有效率81.4%. 不良反应发生率11.3%（8/71）,主要为皮疹、腹泻、血尿素氮升高、转氨酶升高等. 结论 国产硫酸奈替米星治疗感染有效,只要严格按适应证合理使用,不良反应较少,较轻,易于处理. 老年患者应用时需按轻度肾功能减退患者的用法用量减量用药,有变态反应史和年龄偏高患者应慎用.     

奈替米星治疗老年下呼吸道感染及药物浓度测定

观察奈替米星ｑｄ治疗老年下呼吸道感染的临床疗效，体外药物敏感率及病原菌清除情况，了解血浆及气道分泌物中药物浓度、不良反应等。方法：下呼吸道感染老年病人用Ｎｅｔ３００ｍｇ，ｉｖｇｔｔ，ｑｄ，疗程。     

硫酸依替米星治疗细菌性下呼吸道感染

为评价硫酸依替米星治疗细菌性下呼吸道感染的有效性和安全性 ,用硫酸依替米星治疗细菌性下呼吸道感染 30例。 30 0 mg,静脉滴注 ,每日 1次 ,平均疗程 7.5± 2 .3d。临床总有效率 83.3% ,细菌清除率82 .7% ,药敏试验显示分离病原菌对依替米星高度敏感率为 89.6 % ,高于庆大霉素 (P<0 .0 5 ) ,与奈替米星无显著差异 (P>0 .0 5 ) ,未见不良反应。结果表明依替米星治疗细菌性下呼吸道感染有效安全。     

Netilmicin. A review of its antibacterial activity, pharmacokinetic properties and therapeutic use

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.     

Netilmicin Sulfate: A Comparative Evaluation of Antimicrobial Activity,Pharmacokinetics, Adverse Reactions and Clinical Efficacy

Netilmicin, the 1-N-ethyl derivative of sisomicin, is a new aminoglycoside antibiotic that was recently marketed in the United States. Its role in therapeutics is not yet established. The pharmacokinetic profile of netilmicin is very similar to that of gentamicin. Its antimicrobial spectrum and clinical efficacy is similar to that of gentamicin, tobramycin and amikacin. It is less active in vitro against Pseudomonas aeruginosa than gentamicin and tobramycin, but in clinical trials the efficacy of netilmicin against this organism has been similar to other aminoglycosides. Netilmicin is active against some gentamicin and tobramycin-resistant strains of gram-negative bacilli, particularly those harboring adenylating and phosphorylating enzymes. Most of these strains are sensitive to amikacin as well, and amikacin is also active against most netilmicin-resistant strains of these bacteria. Therefore, amikacin remains the aminoglycoside of choice against gentamicin tobramycin and netilmicin-resistant gram-negative bacilli. In comparison to other currently available aminoglycosides, a lower frequency of nephrotoxicity and ototoxicity has been observed in laboratory animals given netilmicin. This has not been unequivocally demonstrated in humans. The frequency of nephrotoxicity in humans has been similar to that of other aminoglycosides. The frequency of ototoxicity associated with netilmicin in humans has been low but not significantly less than with other aminoglycosides, except in one trial. If further studies document a significantly lower frequency of ototoxicity with netilmicin, it may become the aminoglycoside of choice for patients with significant risk factors for ototoxicity, such as advanced age, renal impairment, concomitant ototoxic drug therapy and prolonged aminoglycoside administration.     

硫酸依替米星治疗细菌性感染临床评价

采用非盲法多中心平行开放试验研究硫酸依替米星治疗急性细菌性感染的安全性及有效性。用药方案为每次 10 0～ 15 0 mg,静脉滴注 qd或 q12 h,疗程 7～ 10 d,共完成合格病例 134例 ,其中 111例细菌培养阳性 (82 .84% )。结果显示 :对 134例不同感染病种患者的临床有效率为 90 .2 9% ,对 111例不同细菌感染患者的临床有效率及细菌清除率均为 90 .0 9% ,不良反应发生率为 6 .72 % ,反应程度轻微。纸片药敏试验结果显示细菌对依替米星的敏感率与奈替米星相似 ,高于庆大霉素 (P<0 .0 5 )。结论 :硫酸依替米星是一个安全有效的治疗急性细菌性感染的抗菌药物。     

A comparative study of gentamicin and netilmicin in the treatment of gram-negative infections

Netilmicin is active in vitro against a wide variety of gram-negative bacteria, including certain gentamicin-resistant isolates, and Staphylococcus aureus. This study presents the results of a prospective, randomized, double-blinded protocol designed to determine the relative efficacy and toxicity of netilmicin and gentamicin in the therapy of gram-negative infections. The demographic make-up of both treatment groups was similar. Cure rates were 96.7 percent with netilmicin and 94.4 percent with gentamicin. Possible transient nephrotoxicity developed in nine patients receiving netilmicin and in eight patients receiving gentamicin.     

硫酸依替米星治疗下呼吸道感染的临床研究

采用开放对比研究比较硫酸依替米星 (ETM)与奈替米星 (NTL)以评价 ETM治疗下呼吸道感染的疗效和安全性。选择未用过抗生素治疗或虽用抗菌药物但无效的下呼吸道感染的住院病人 6 4例 ,随机分成两组 ,分别给 ETM或 NTL。结果显示 ,ETM与 NTL的有效率分别为 87.5 % (2 8/ 32 )及 90 .6 % (2 9/ 32 ) ,细菌清除率为 87.5 % (2 1/ 2 4)与 83.33% (2 0 / 2 4) ,不良反应发生率为 6 .2 5 % (2 / 32 )与 3.12 % (1/ 32 )。两组比较差异均无显著性。提示 ETM与 NTL相仿 ,抗菌谱广 ,疗效好 ,不良反应少 ,对下呼吸道感染有效且安全。     

依替米星与奈替米星治疗下呼吸道细菌感染临床疗效及安全性比较

目的 :比较依替米星与奈替米星治疗下呼吸道细菌感染的疗效及安全性。方法 :采用随机对照试验方法。依替米星与奈替米星剂量均为 1 0 0mg ,溶于 1 0 0mL氯化钠注射液中静脉滴注 ,bid,疗程 5～ 1 2d。入选病例 1 65例 ,其中依替米星组 82例 [男性 43例 ,女性 39例 ,年龄 (44±s1 3)a] ,临床疗效评价病例 80例 ,安全性评价 82例 ;奈替米星组83例 [男性 45例 ,女性 38例 ,年龄 (44± 1 3)a] ,临床疗效评价病例 80例 ,安全性评价 83例。结果 :依替米星与奈替米星组总有效率分别为 89%和86 % ,细菌清除率分别为 86 %和 84% ,药物不良反应发生率分别为 5 %和 6 % ,2组比较差别均无显著意义 (P >0 .0 5)。结论 :依替米星治疗下呼吸道细菌感染安全、有效 ,与奈替米星相似     

Netilmicin synergy with carbenicillin or cefamandole against Serratia

Twenty clinical isolates of Serratia sp. were tested against netilmicin, gentamicin, carbenicillin and cefamandole alone (broth and agar dilution) and in combination (agar dilution). Broth and agar dilution minimal inhibitory concentrations agreed to within a two-fold dilution in 96% of the tests. Overall, 95% of the isolates were susceptible to netilmicin regardless of susceptibility to gentamicin or carbenicillin. Netilmicin-carbenicillin synergy was seen in 55% of the strains and netilmicin-cefamandole in 70%. These results indicate that combinations of netilmicin with carbenicillin or cefamandole may be clinically useful.     

国产与进口头孢吡肟治疗下呼吸道细菌性感染120例疗效与安全性

目的：评价国产头孢吡肟治疗下呼吸道细菌感染的疗效及安全性。方法：采用多中心随机双盲对照临床试验设计,选用121例18～65 a的病人随机分配到试验组(国产头孢吡肟)61例和对照组(进口头孢吡肟)60例。给药方案均为2 g,iv,gtt,bid,疗程为7～14 d。结果：试验组与对照组的痊愈率与有效率分别为66%,98%与80%,100%,细菌阳性率分别为79%与83%,细菌清除率分别为98%与100%,不良反应发生率分别为10%与3%(P＞0.05)。结论：国产头孢吡肟是治疗下呼吸道细菌感染的有效和安全的药物,与进口头孢吡肟相当。