[Clinical studies on gentamicin (author's transl)]

Area of Science:

• Pharmacology and Microbiology
• Nephrology
• Clinical Medicine

Background:

• Gentamicin (GM) is a widely used antibiotic.
• Understanding its evolving antibacterial spectrum, pharmacokinetic profile, and potential toxicities is crucial for effective clinical application.

Purpose of the Study:

• To evaluate the current antibacterial activity of Gentamicin.
• To assess Gentamicin's absorption, excretion, and effects on kidney function.
• To determine the clinical efficacy and safety of Gentamicin in treating infections.

Main Methods:

• Antibacterial susceptibility testing of common pathogens.
• Pharmacokinetic studies involving blood and urine level analysis after intramuscular injection.
• Nephrotoxicity assessment in rats and histopathological examination of kidney tissue.
• Clinical trial evaluating Gentamicin in patients with various infections.

Main Results:

• Antibacterial activity against E. coli, Klebsiella, and Proteus mirabilis remained stable; however, resistance in Pseudomonas aeruginosa increased from 0% to 12.7%.
• Peak blood levels and absorption half-life showed a dose-dependent relationship after intramuscular administration.
• Urinary levels peaked within 2 hours, with approximately 44% recovery over 6 hours.
• Rat studies indicated mild nephrotoxicity, comparable to kanamycin, with increased BUN and decreased urinary osmotic pressure.
• Clinical trials in 22 patients showed a 90.9% efficacy rate for various infections, with no serious adverse events reported.

Conclusions:

• Gentamicin remains effective against many common bacteria, but emerging resistance in P. aeruginosa warrants monitoring.
• The drug exhibits predictable pharmacokinetics and a dose-dependent absorption profile.
• Nephrotoxicity, although present, appears comparable to other aminoglycosides like kanamycin.
• Gentamicin demonstrates significant clinical effectiveness and a favorable safety profile in treating diverse infections.