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Aminoglycoside-induced nephrotoxicity

Kurt A Wargo1, Jonathan D Edwards2

  • 1Division of Internal Medicine, Auburn University Harrison School of Pharmacy, Huntsville, AL, USA wargoka@auburn.edu.

Journal of Pharmacy Practice
|September 10, 2014
PubMed

Insights

Aminoglycosides, effective against Gram-negative bacteria, can cause ototoxicity and nephrotoxicity. This review examines aminoglycoside-induced nephrotoxicity mechanisms, risks, and prevention strategies amid rising antimicrobial resistance.

Area of Science:

  • Pharmacology
  • Microbiology
  • Nephrology

Background:

  • Aminoglycosides are critical antibiotics for serious Gram-negative bacterial infections.
  • Common agents include gentamicin, tobramycin, and amikacin, acting as concentration-dependent bactericidal drugs.
  • Their use declined due to toxic effects like ototoxicity and nephrotoxicity, but rising antimicrobial resistance prompts reevaluation.

Purpose of the Study:

  • To review the mechanisms and risk factors of aminoglycoside-induced nephrotoxicity.
  • To discuss strategies for preventing nephrotoxicity in patients receiving aminoglycosides.

Main Methods:

  • Literature review of studies on aminoglycoside pharmacology and toxicology.
  • Analysis of clinical data regarding nephrotoxicity incidence and risk factors.
  • Synthesis of evidence-based prevention strategies.

Main Results:

  • Aminoglycosides inhibit bacterial protein synthesis by targeting the 30S ribosomal subunit.
  • Nephrotoxicity is a significant dose-dependent adverse effect.
  • Risk factors include patient comorbidities, concomitant medications, and specific aminoglycoside agents.

Conclusions:

  • Revisiting aminoglycoside use is crucial due to multi-drug resistance.
  • Understanding nephrotoxicity mechanisms and risk factors is key for safe clinical application.
  • Implementing preventive strategies can mitigate renal damage and optimize patient outcomes.
Keywords:
AminoglycosideDosingNephrotoxicity

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