PHARMACOKINETICS AND TISSUE PENETRATION OF A SINGLE-DOSE OF NETILMICIN AS ANTIBIOTIC-PROPHYLAXIS IN COLORECTAL SURGERY

The pharmacokinetics, serum levels and tissue penetration of netilmici n were studied after a single intravenous injection of 6 mg/kg. 13.pat ients scheduled for elective colorectal surgery and for antibiotic pro phylaxis were given a combination of netilmicin and a single dose of o rnidazole (1000 mg intravenously). Mean maximal (10 minutes) and last determined (24-hour) netilmicin serum levels were 24.4 +/- 3.4 and 0.9 +/- 0.5 mg/L, respectively. The beta-phase elimination half-life was 413 +/- 68 minutes, and the apparent volume of distribution and cleara nce were 0.51 +/- 0.12 L/kg and 0.07 +/- 0.02 L/min, respectively. In all patients, adequate tissue levels (greater-than-or-equal-to MIC90 o f pathogens) were found in the abdominal wall and epiploic fat at the time of incision and in the colonic wall at the time of anastomosis. A t the time of closure, all but 1 patient had adequate tissue levels in the abdominal wall and epiploic fat. Further studies are needed to fu lly determine the clinical implications of these results but, in view of its pharmacokinetic properties, netilmicin, in combination with orn idazole, can be considered for antibiotic prophylaxis.