Aminoglycoside antibiotics are among the newest and most effective antibiotics currently available. However, they also have some of the worst and most dangerous side effects of all the anitbiotics. They are usually reserved for infections that are not responsive to first-line therapy. Due to the advertising involved in the pharmaceutical business, these antibiotics are being overused for conditions where they are not warranted, since patients often demand antibiotics by name now. Unfortunately, chances are good that this will lead to aminoglycoside-resistant bugs in the very near future.
Aminoglycoside antibiotics
Brand/Generic Drug Names
Amikin/amikacin, Zithromax/azithromycin, clarithromycin, Garamycin/gentamycin, Kantrex/kanamycin, Mycifradin/neomycin, streptomycin, Nebcin/tobramycin
Common uses
with penicillins, cephalosporins, vancomycin for synergistic effect, gram-negative infections
Pharmacology
irreversibly bind ribosomes, inhibiting protein synthesis and causing death in susceptible organisms
Class contraindications
allergy, cross-sensitivity
Class precautions
infants w. botulism, elderly, myasthenia gravis, Parkinsonism, 8th cranial nerve impairment, impaired renal function
Interactions
Increased neuromuscular blockade: anesthetics, citrate-anticoagulated blood, neuromuscular blocking agents, capreomycin, other aminoglycosides
Increased nephrotoxicity: methoxyflurane, polymyxins, capreomycin, other aminoglycosides and nephrotoxic drugs
Increased ototoxicity: amphotericin B, aspirin, bacitracin, bumetanide, cephalothin, cisplatin, cyclosporine, ethacrynate sodium, Furosemide, paromyomycin, streptozocin, vancomycin, capreomycin, other aminoglycosides
Adverse Reactions
nephrotoxicity, neurotoxicity, ototoxicity, hypersensitivity
Additional Information
Assess blood and renal studies, audiogram, vestibular function
Assess bowel pattern, urine output daily
Assess for anaphylaxis, bleeding, overgrowth of infection
Ensure culture and sensitivity is taken before beginning therapy
Monitor peak and trough levels
Administer for 10-14 days to ensure death of organism
Evaluate therapeutic response: absence of fever, malaise, fatigue, draining wounds, negative culture and sensitivity for causative organism
Date of most recent Update
August 08, 2002
Further information is available in the writeup for the
specific name(s) of this medication class