Avaliaçäo da concentraçäo inibitória mínima da ceftriaxona e de aminoglicosídeos em enterobactérias em condiçöes aeróbicas e anaeróbicas / Evaluation of minimal inhibitory concentration of ceftriaxone and aminoglycosides against enterobacteria under aerobic and anaerobic conditions

Alguns trabalhos têm demonstrado que os aminoglicosídeos apresentam uma reduçäo in vitro de sua atividade frente às enterobactérias e ao S. aureus em meios anaeróbicos. O objetivo do estudo foi o de comprovar a atividade da ceftriaxona, netilmicina e gentamicina em 30 cepas de enterobactérias isoladas de infecçöes intra e extra-hospitalares, em condiçöes de anaerobiose e aerobiose. O método para a determinaçäo da MIC foi o da diluiçäo. Os resultados demonstram que a netilmicina e gentamicina perdem (em algumas cepas) a sua atividade em condiçöes de anaerobiose, o mesmo näo ocorrendo com a ceftriaxona. Esses achados sugerem que a ceftriaxona deve ser o antibiótico de eleiçäo, nas infecçöes causadas por enterobactérias onde se suspeite de baixos níveis de oxigênio

Clinical pharmacology of netilmicin in preterm and term newborn infants.

Sixty-four neonates, with gestational age ranging from 27 1/2 to 40 weeks, postnatal age from 1 to 15 days, and birth weight from 800 to 3400 gm, were given netilmicin 2.5 mg/kg intramuscularly two or three times per day according to postnatal age, for 5 to 14 days. Serum concentrations were measured before and 1 hour after a dose at least twice during treatment. The serum washout profile of the drug was observed in 22 neonates after discontinuation of therapy. Renal function was studied in 37 infants by measuring serum creatinine concentrations and in 27 by urinary excretion of N-acetyl-glucosaminidase during and up to 15 days after therapy. Behavioral and impedance audiometry, and in infants failing those, auditory brainstem evoked response tests, were performed between 6 and 12 months of age. In 23.5% of the neonates, trough serum levels were greater than 3 micrograms/ml. The serum washout followed a multiexponential decay, accounting for distributional, rapid (initial), and slow (tissue) elimination phases. Linear regression analysis performed between each kinetic parameter and gestational age or birth weight showed that initial elimination half-life, steady-state volume of distribution, and total body clearance were significantly correlated with both variables. Netilmicin did not cause detectable renal or auditory damage.