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Antimicrobial Peptides Produced by Selective Pressure Incorporation of Non-canonical Amino Acids
11:56

Antimicrobial Peptides Produced by Selective Pressure Incorporation of Non-canonical Amino Acids

Published on: May 4, 2018

The aminoglycosides

A Whelton

    Clinical Orthopaedics and Related Research
    |November 1, 1984
    PubMed

    Insights

    Aminoglycoside antibiotics are vital for gram-negative infections but can cause kidney and ear toxicity. Careful dosing and hydration minimize these risks, allowing safe use in bone cements for orthopedic infections.

    Area of Science:

    • Pharmacology
    • Infectious Diseases
    • Nephrology

    Background:

    • Aminoglycoside antibiotics are essential for treating serious aerobic gram-negative bacterial infections.
    • Annually, approximately 4 million patients in the U.S. are treated with aminoglycosides.
    • While highly effective, aminoglycosides carry risks of nephrotoxicity and ototoxicity.

    Purpose of the Study:

    • To review the clinical utility and toxicologic concerns associated with aminoglycoside antibiotics.
    • To discuss strategies for minimizing aminoglycoside-induced toxicity.
    • To explore the potential of aminoglycosides in orthopedic surgical infection prophylaxis and treatment via bone cement delivery systems.

    Main Methods:

    • Literature review focusing on clinical efficacy, toxicity profiles, and drug delivery systems of aminoglycosides.
    • Analysis of factors influencing aminoglycoside-related side effects, including dosage, duration, and patient hydration.
    • Evaluation of the chemical and microbiological properties of aminoglycosides for incorporation into polymethylmethacrylate bone cements.

    Main Results:

    • Aminoglycosides demonstrate unparalleled clinical efficacy against aerobic gram-negative pathogens.
    • Nephrotoxicity and ototoxicity are significant, dose-dependent adverse effects requiring careful patient monitoring.
    • Optimizing aminoglycoside dosage, treatment duration, and patient hydration status can substantially mitigate toxicity.
    • Aminoglycosides exhibit favorable characteristics for use in polymethylmethacrylate bone cements.

    Conclusions:

    • Aminoglycosides remain critical for managing complex gram-negative infections.
    • Judicious clinical management, including dose and hydration monitoring, is key to minimizing aminoglycoside toxicity.
    • The properties of aminoglycosides make them suitable for local delivery in orthopedic surgery to combat infections.

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