OBJECTIVE:To study the effects of total parenteral nutrition (TPN) on the pharmacoknetics of netilmicin (NTM) in patients.METHODS:Seven patients with intestines fistula under TPN and seven control patients received 5mg·kg^-1 NTM by iv infusion in 0.5h.NTM concentrations in serum and urine were determined by a high-performance liquid chromatography-indirect photometric determination (HPLC-IPD) method.Pharmacokinetic parameters were calculated with a PKPB-NI program.RESULTS:After intravenous administration of NTM 5mg·kg^-1,the NTM peak concentration in serum was not significantly lower in the TPN group than the control group(P>0.05),but the NTM level of the TPN group was higher than control (P>0.05) at 5h after administration and significantly higher at 12h (P<0.05).The excretion of parental NTM in urine were (52±13)% in the TPN group and (63±15)% in the control.The pharmacokinetics of NTM were disposed in a two-compartment open model with t_1/2β=(5.8±1.6)h and V_c=(0.47±0.15)L·kg^-1 in the TPN group,t_1/2β=(3.5±1.4)h and V_c=(0.28±0.09)L·kg^-1 in control,respectively.CONCLUSION:The results suggested that there would be a marked drop in the distribution and elimination of NTM in the patients under TPN.