Tobramycin in the treatment of peritonitis

Tobramycin is a new aminoglycosidic aminocyclitol antibiotic which has a broad spectrum of activity against aerobic and facultative Gram-negative bacilli. It is particularly effective against Pseudomonas aeruginosa, including some strains of this organism which are resistant to gentamicin. The newer aminoglycosidic aminocyclitol antibiotics all consist of a "backbone" of 2-deoxystreptamine, to which are attached several amino-containing sugar groups. These agents inhibit protein synthesis in bacteria at the level of the ribosome and are bactericidal although the precise mechanism by which they kill bacteria is still not known. There are a number of processes by which bacteria can become resistant to the action of the aminoglycosidic aminocyclitol antibiotics. Among these, the ability of bacteria to produce inactivating enzymes (usually mediated by R-factors or plasmids) appears to be the most important in current clinical isolates of bacteria. Aminoglycosidic aminocyclitol antibiotics which are resistant to these enzymes may have an enhanced spectrum of activity.