NERROMICINE - instructions for use, analogs, reviews and release forms (injections in ampoules for injection in a solution of 25 mg, 50 mg, 100 mg and 200 mg) drugs for the treatment of pneumonia, pyelonephritis, peritonitis in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Netromycin. Comments of visitors of the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Netromycin in their practice are presented. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Netromycin in the presence of existing structural analogues.Use for the treatment of pneumonia, pyelonephritis and peritonitis in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Netromycin - a semisynthetic antibiotic of a broad spectrum from the group of aminoglycosides of the 3rd generation, a derivative of sizomycin. Soluble in water. Possesses bactericidal action. It binds to the ribosomes of the bacterial cell and disrupts the synthesis of the protein, preventing the formation of a complex of transport and matrix RNA, with an erroneous reading of the genetic code and the formation of non-functional proteins. In high concentrations, it breaks the permeability of the cytoplasmic membrane and causes the death of microorganisms.

Highly active against gram-negative bacteria: Escherichia coli (E. coli), Klebsiella spp. (Klebsiella), Enterobacterspp., Serratiaspp., Shigellaspp. (Shigella), Salmonellaspp. (Salmonella), Citrobacterspp., Proteusspp. (indole-positive and indolotric), Proteus mirabilis, Proteus vulgaris, Morganella morganii, Providencia rettgeri, Pseudomonas aeruginosa, Neisseria gonorrhoeae, and some Gram-positive microorganisms, in particular Staphylococcus spp. (staphylococcus) (penicillin and methicillin-resistant strains).

Composition

Nethylmicin sulfate + auxiliary substances.

Pharmacokinetics

After intramuscular injection, the maximum concentration of Netromycin in the blood plasma is reached after 0.5-1 hour. The same concentration is determined 1 hour after intravenous infusion in the same dose. After rapid intravenous administration, a transient increase in the maximum plasma concentration is possible 2-3 times compared with intravenous infusion. The elimination half-life of Netromycin is 2-2.5 hours. About 80% is excreted in the urine within 24 hours.

Indications

• bacteremia (the presence of bacteria in the blood);
• septicemia, including neonatal sepsis;
• acute uncomplicated gonococcal infection;
• acute and chronic sinusitis (inflammation of the paranasal sinuses);
• acute and chronic pharyngitis (inflammation of the mucous membrane of the pharynx);
• acute and chronic tonsillitis (inflammation of the tonsils);
• acute and chronic laryngitis and tracheitis (inflammation of the mucous larynx and trachea);
• acute and chronic bronchitis;
• bacterial pneumonia (pneumonia);
• acute peritonitis (inflammation of the peritoneum);
• acute cholecystitis (inflammation of the gallbladder);
• Cholangitis (inflammation of the bile ducts);
• impetigo, pyoderma (pustular skin diseases);
• abscess and phlegmon (purulent inflammation of the subcutaneous tissue);
• furuncle, carbuncle (inflammation of the hair follicles);
• pyogenic arthritis (purulent inflammation of the joint);
• osteomyelitis (purulent-necrotic process in the bone);
• urethritis and urethral syndrome (inflammation of the urethral mucosa);
• cystitis (inflammation of the bladder);
• acute and chronic pyelonephritis (inflammation of the renal pelvis);
• prostatitis;
• Salpingitis and oophoritis (inflammation of the fallopian tubes, ovaries);
• inflammatory diseases of the uterus (endometritis, abscess, endocervicitis);
• infected wounds and burns;
• postoperative infection.

Forms of release

Solution for injection 25 mg / ml, 50 mg / 2 ml, 100 mg / ml, 200 mg / 2 ml in a vial (injections in ampoules).

Instructions for use and dosing regimen

Enter intramuscularly or intravenously. Introduction to the vein should be a Priority choice in the therapy of patients with septicemia, as well as patients who are in a state of shock. In addition, the introduction of a vein is more effective in the treatment of patients with hematologic disorders, a chronic form of heart failure, decreased muscle mass and severe burns.

When infusional introduction to adult patients, a single dose of Netilmicin is dissolved in 50-200 ml of 0.9% sodium chloride for infusion or 5% aqueous glucose for infusion.

For adults, the daily dose is 4-6 mg / kg, with a severe course of the disease, the daily dose can be increased to 7.5 mg / kg.

For children, the daily dose is 6-7.5 mg / kg.

For newborns over 1 week and infants, the daily dose is 7.5-9 mg / kg, for preterm infants and newborns under 1 week, the daily dose is 6 mg / kg.

Multiplicity of administration and duration of treatment are set individually. The average duration of therapy is 7-14 days, with severe infections with complications may require a longer course of treatment.

If the renal function is impaired, correction of the dosage regimen of Nethylmycin is required.

Side effect

• hearing loss;
• dizziness;
• noise in ears;
• neuromuscular blockade (impairment of transmission of nerve impulses);
• vomiting;
• diarrhea or diarrhea;
• increased activity of hepatic transaminases and alkaline phosphatase in blood serum;
• increased bilirubin concentration;
• tachycardia (heart palpitations);
• hypotension (low blood pressure);
• skin rash;
• eosinophilia (increase in the number of eosinophils in the blood);
• soreness at the injection site;
• fever;
• hematuria (blood in the urine);
• proteinuria (protein in the urine is higher than normal);
• cylindruria (cylinders in urine above the norm);
• decreased creatinine clearance;
• increasing the concentration of creatinine and residual nitrogen in the blood serum;
• anemia (decrease in hemoglobin level);
• leukopenia (decrease in the number of leukocytes in the blood);
• thrombocytopenia (decrease in the number of platelets in the blood).

Contraindications

• increased sensitivity to netilmicin;
• increased sensitivity to antibiotics of the aminoglycoside group in the anamnesis.

Application in pregnancy and lactation

Netromycin penetrates the placental barrier and is not a drug of choice in the treatment of infectious diseases in pregnant women. Aminoglycosides may increase the likelihood of developing fetal abnormalities. In the course of the study, the occurrence of irreversible total bilateral congenital deafness was reported in children whose mothers received aminoglycoside therapy during pregnancy. It is forbidden to prescribe the preparation of Nerromycin to pregnant women, except for vital indications.

Netilmicin penetrates into breast milk and is not a drug of choice in the therapy of women during lactation. If it is impossible to avoid therapy with the drug Nerromycin, the specialist should decide on the completion of breastfeeding.

Use in children

Children prescribe drugs depending on their age. Newborns, including those aged 1 week or less, are given a dose of 6 mg / kg per day (3 mg / kg administered every 12 hours). Children aged 1 week to 1 year - from 7.5 to 9.0 mg / kg per day (2.5-3.0 mg / kg administered every 8 hours). Children older than 1 year - from 6.0 to 7.5 mg / kg per day (2.0-2.5 mg / kg administered every 8 hours).

Application in elderly patients

The risk of toxic side effects is increased in elderly patients.

special instructions

They are used with caution in patients with myasthenia gravis, parkinsonism, as well as in children with botulism.

Treatment should be carried out under the supervision of a doctor.

It is necessary to conduct a regular urinalysis, monitor serum urea, creatinine, and creatinine clearance. It is recommended to take serial audiograms (especially in patients with an increased risk of ototoxicity).

The risk of toxic side effects increased with the use of NEROMICIN in high doses, with a long course of treatment, in patients with impaired renal function and in elderly patients.

During the treatment period, the concentration of the drug in the blood plasma should be monitored. It is necessary to avoid prolonged excess of the maximum concentration of more than 16 μg / ml. The minimum concentrations of Nethylmicin, determined in the plasma before the introduction of the next dose, should be in the range of 0.5-2 μg / ml.

Drug Interactions

The risk of nephrotoxic and neurotoxic effects increases with the simultaneous or sequential use of NEROMICIN and the following medications: cisplatin, bacitracin, polymyxin B, colistin, cefaloridine, amphotericin B, acyclovir, loop diuretics, viomycin, vancomycin, kanamycin, gentamicin, amikacin, sisomycin , tobramycin, neomycin, streptomycin, paromomycin.

Analogues of the drug Nerromycin

Structural analogs for the active substance:

• Vero-Netilmitsin;
• Nettavisk;
• Nettacine;
• Netilmicin Protek;
• Nethylmicin sulfate.

Analogues for the pharmacological group (aminoglycosides):

• Alemtob;
• Amycocal;
• Amicacin;
• Amikin;
• Amycositis;
• Amintaks;
• Baneocin;
• Bramitob;
• Brulamycin;
• Gyramycin;
• Gentamicin;
• Dilaterol;
• Isophra;
• Kanamycin;
• Kirin;
• Ligent;
• Lycasin;
• Nebzin;
• Neomycin;
• Nettavisk;
• Nettacine;
• Polizhinaks;
• Selemycin;
• Streptomycin;
• Toby;
• Tobramycin;
• Teborocin ADS;
• Tobrex;
• Tobrisse;
• Tobrup;
• Tobrosolt;
• Triassept;
• Trobitsin;
• Trophodermine;
• Farcicline;
• Fugentin;
• Hemacin.

Doctor's Feedbackinfectious disease

Preparations of the aminoglycoside group are less and less used for the treatment of infectious diseases. This is due to their high oto- and nephrotoxicity. Even considering that Netromycin belongs to the last generation of aminoglycosides with less toxicity, there is a high risk of development of hearing loss after its application, especially in childhood. In hospital, aminoglycosides are prescribed only as a last resort: if there is an allergy to penicillins and cephalosporins and if therapy with other antibiotics proves to be ineffective. In this case, daily monitoring of blood counts and hearing testing (audiogram) is necessary.

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