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The aminoglycosides

A M Ristuccia, B A Cunha

    The Medical Clinics of North America
    |January 1, 1982
    PubMed
    Summary

    Aminoglycosides like gentamicin, tobramycin, and amikacin are vital for treating gram-negative sepsis. Amikacin is currently preferred due to lower resistance and better pharmacokinetics, ensuring continued use alongside new cephalosporins.

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    Postgraduate medicine·2016

    Area of Science:

    • Pharmacology
    • Infectious Diseases
    • Critical Care Medicine

    Background:

    • Aminoglycosides are essential for treating aerobic gram-negative bacterial infections, particularly in hospital settings.
    • Commonly used aminoglycosides include gentamicin, tobramycin, and amikacin, which exhibit similar efficacy against susceptible pathogens.

    Purpose of the Study:

    • To compare the efficacy, resistance patterns, pharmacokinetic profiles, and toxicity of gentamicin, tobramycin, and amikacin.
    • To evaluate the current role and future prospects of aminoglycosides in managing gram-negative infections, especially in light of third-generation cephalosporins.

    Main Methods:

    • Comparative analysis of existing data on aminoglycoside efficacy, resistance, pharmacokinetics, and toxicity.
    • Review of clinical guidelines and research regarding the use of aminoglycosides and third-generation cephalosporins.

    Main Results:

    • Gentamicin, tobramycin, and amikacin show comparable efficacy but differ in resistance profiles and pharmacokinetics.
    • Amikacin is favored for general use due to its lower resistance potential, superior pharmacokinetic profile (predictable peaks, wide therapeutic ratio, high "kill ratio"), and convenient dosing (every 12 hours).
    • The ototoxicity and nephrotoxicity of these three aminoglycosides are considered comparable.

    Conclusions:

    • Aminoglycosides remain crucial for treating serious gram-negative infections.
    • Amikacin's favorable characteristics make it a preferred choice for current clinical practice.
    • The introduction of third-generation cephalosporins is expected to prolong the utility of aminoglycosides, likely through combination therapy for extended spectrum and potential synergistic effects.

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