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Should aminoglycoside antibiotics be abandoned?
1Department of Surgery, University of Mississippi Medical Center, and the G. V. (Sonny) Montgomery Veterans Affairs Medical Center, Jackson, Mississippi 39216-5199, USA.
American Journal of Surgery
|February 22, 2001
Summary
Aminoglycosides cause significant kidney damage. Alternative antibiotics demonstrate superior or equal effectiveness against Gram-negative rods and Pseudomonas, making aminoglycoside use rarely necessary.
Area of Science:
- Infectious Diseases
- Pharmacology
- Nephrology
Background:
- Aminoglycosides are associated with nephrotoxicity and ototoxicity.
- Safer alternative antibiotics are available for clinical use.
Purpose of the Study:
- To evaluate the incidence of aminoglycoside-induced nephrotoxicity.
- To compare the efficacy of aminoglycosides with alternative antibiotics against Gram-negative rods (GNRs).
Main Methods:
- Retrospective review of surgical service antibiotic use, aminoglycoside toxicity, and perioperative culture/sensitivity data.
- Analysis of 289 positive cultures from 243 patients between July 1998 and June 1999.
Main Results:
- Aminoglycosides were used in 26 patients, with 15% experiencing nephrotoxicity.
- Ceftazidime showed 99% sensitivity against GNRs, significantly outperforming amikacin, gentamicin, and tobramycin.
- Cefuroxime demonstrated comparable sensitivity to gentamicin and tobramycin, with 43% of GNRs resistant to gentamicin/tobramycin also being Pseudomonas aeruginosa.
Conclusions:
- Aminoglycosides are linked to a notable rate of nephrotoxicity.
- Alternative antibiotics offer superior or equivalent sensitivity profiles against GNRs and Pseudomonas.
- The clinical indication for aminoglycoside use is minimal.