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Related Concept Videos

Inhibitors of Bacterial Protein Synthesis01:25

Inhibitors of Bacterial Protein Synthesis

Aminoglycosides constitute a highly potent class of bactericidal antibiotics that exert their antimicrobial effects by targeting the bacterial ribosome, specifically disrupting protein synthesis. These polycationic molecules consist of amino-modified sugars linked via glycosidic bonds to an aminocyclitol core such as 2-deoxystreptamine or streptamine. Their strong positive charges facilitate tight binding to the negatively charged phosphate backbone of ribosomal RNA (rRNA), primarily at the 16S...
Estimation of k and VD of Aminoglycosides01:20

Estimation of k and VD of Aminoglycosides

Aminoglycosides are a class of antibiotics used to treat various bacterial infections. Clinicians must determine the elimination rate constant (k) and volume of distribution (VD) to optimize therapeutic efficacy and minimize toxicity. The k value represents the rate at which the drug is removed from the body, and the VD reflects the degree to which the drug distributes into body tissues. Accurately estimating these parameters allows healthcare professionals to tailor drug dosing to individual...
Inhibitors of Bacterial DNA Synthesis01:28

Inhibitors of Bacterial DNA Synthesis

Bacterial pathogens depend on precise and efficient DNA replication to sustain infection. Two type II topoisomerases—DNA gyrase and topoisomerase IV—are critical to this process, as they resolve DNA supercoiling and unlink chromosomes during replication. Fluoroquinolones, synthetic derivatives of quinolones, exploit this mechanism by stabilizing the transient DNA–enzyme cleavage complex, preventing strand religation, and causing lethal double-strand breaks. These antibiotics are selectively...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Clinical Significance of Antibiotic Resistance01:25

Clinical Significance of Antibiotic Resistance

Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...
Mechanism of Antibiotic Resistance in MRSA01:25

Mechanism of Antibiotic Resistance in MRSA

Antibiotic resistance in bacteria arises when microorganisms evolve the ability to withstand drugs designed to kill them or inhibit their growth, rendering once-effective treatments useless. This phenomenon, driven by genetic change and selection under antibiotic exposure, poses a profound threat to modern medicine. Mechanisms include drug-inactivating enzymes (e.g., β-lactamases), efflux pumps that eject antibiotics, mutations altering antibiotic targets, decreased drug uptake, and acquisition...

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Generating Transposon Insertion Libraries in Gram-Negative Bacteria for High-Throughput Sequencing
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Do we still need the aminoglycosides?

Emanuele Durante-Mangoni1, Alexandros Grammatikos, Riccardo Utili

  • 1Unit of Infectious & Transplant Medicine, 2nd University of Naples, Monaldi Hospital, Naples, Italy.

International Journal of Antimicrobial Agents
|November 4, 2008
PubMed
Summary

Aminoglycoside antibiotics remain valuable for treating Gram-negative bacterial infections, despite toxicity concerns. Advances in dosing strategies and retained antimicrobial activity support their continued clinical use.

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Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Microbiology

Background:

  • Aminoglycoside antibiotics have been in clinical use for decades.
  • Newer antibiotics with better safety profiles have emerged, questioning aminoglycoside utility.
  • Rising antimicrobial resistance in Gram-negative bacteria necessitates re-evaluation of older agents.

Purpose of the Study:

  • To reassess the clinical value of aminoglycoside antibiotics in light of emerging resistance.
  • To address the ongoing debate concerning aminoglycoside antimicrobial spectrum and toxicity.
  • To explore the impact of recent advances in understanding aminoglycoside dosing and safety.

Main Methods:

  • Review of existing literature on aminoglycoside efficacy and toxicity.
  • Analysis of current trends in Gram-negative bacterial resistance patterns.
  • Evaluation of updated knowledge on aminoglycoside pharmacokinetic/pharmacodynamic properties and dosing.

Main Results:

  • Aminoglycosides retain significant activity against many Gram-negative bacterial isolates globally.
  • Nephrotoxicity and ototoxicity remain significant concerns limiting routine use.
  • Understanding of how different dosage schedules affect toxicity has advanced.

Conclusions:

  • Despite toxicity, aminoglycosides remain a valuable therapeutic option for Gram-negative infections.
  • Optimized dosing strategies can mitigate risks associated with aminoglycoside use.
  • The retained antimicrobial spectrum of aminoglycosides is crucial in the era of increasing resistance.