Applies to the following strengths: 100 mg/mL
Usual Adult Dose for:
Additional dosage information:
Usual Adult Dose for Bacterial Infection
Serious systemic infections: 4 to 6.5 mg/kg/day in divided doses every 8 to 12 hours.
Usual Adult Dose for Urinary Tract Infection
Complicated: 3 to 4 mg/kg/day in 2 divided doses every 12 hours.
Renal Dose Adjustments
CrCl 20 to 40 mL/min: The usual dose should be administered every 24 hours.
CrCl 40 to 60 mL/min: The usual dose should be administered every 12 hours.
Liver Dose Adjustments
No adjustment required
The dosage in obese patients should be based on lean body mass. In patients with extensive body surface burns, altered pharmacokinetics may result in reduced serum levels of aminoglycosides. Measurement of netilmicin serum levels is particularly important as a basis for dosage adjustment in such patients.
Administration of injections preserved with benzyl alcohol has been associated with toxicity in neonates. Caution should be used when netilmicin is administered to neonates and children.
Although prolonged courses of netilmicin injection have been well tolerated, it is particularly important that patients treated for longer than the usual period be carefully monitored for changes in renal, auditory, and vestibular functions.
In adults, a dose of 2 mg/kg at the end of each dialysis period is recommended until the results of tests measuring netilmicin serum levels become available. Dosage should then be appropriately adjusted based on these tests.
Generally, each individual dose should not exceed 3.25 mg/kg. It is desirable to limit the duration of treatment with aminoglycosides to short-term whenever feasible. The usual duration of treatment for all patients is 7 to 14 days. In complicated infections, a longer course of therapy may be necessary. It is desirable to measure both peak and trough serum levels of netilmicin to determine the adequacy and safety of the administered dosage. When such measurements are feasible, they should be carried out periodically during therapy. Peak serum levels are expected to range from 4 to 12 mcg/mL. Dosage should be adjusted to attain the desired peak and trough levels and to avoid prolonged peak serum levels above 16 mcg/mL. When monitoring trough levels (just prior to the next dose), dosage should be adjusted so that levels above 4 mcg/mL are avoided. Interpatient variation of aminoglycoside serum levels occurs in patients with normal or abnormal renal function. Generally, desirable peak and trough levels will be in the range of 6 to 10 and 0.5 to 2 mcg/mL, respectively.
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