Netilmicin sulfate is primarily used as an antibiotic to treat serious bacterial infections. It is effective against a wide range of Gram-negative and some Gram-positive bacteria. Common applications include treating urinary tract infections, respiratory tract infections, septicemia, and infections in the abdomen. It is also used in surgical prophylaxis to prevent infections during or after operations. Due to its potency, it is often reserved for cases where other antibiotics have failed or are unsuitable. It is administered via injection, typically in a hospital setting, under close medical supervision to monitor for potential side effects such as kidney or hearing damage.