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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

Insights

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.

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.

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