Aminoglycosides are a group of bactericidal antibiotics, which act by inhibiting bacterial protein synthesis. Their use is restricted because of potential side effects, as they can cause ear and kidney damage.
All aminoglycosides cause:
• Renal toxicity (often reversible)
• Vestibular and auditory toxicity (often irreversible)
• Prolongation of effects of neuromuscular blockers
Aminoglycosides are infrequently used alone, typically for plague and tularemia. They are usually used with a broad-spectrum β-lactam for severe infection suspected to be due to a gram-negative bacillary species. However, because of increasing aminoglycoside resistance, a fluoroquinolone can be substituted for the aminoglycoside in initial empiric regimens, or if the pathogen is found to be susceptible to the accompanying antibiotic, the aminoglycoside can be stopped after 2 to 3 days unless an aminoglycoside-sensitive P. aeruginosa is identified.
Aminoglycosides that are active against P. aeruginosa include tobramycin (particularly), gentamicin, and amikacin. Streptomycin, neomycin, and kanamycin are not active against P. aeruginosa. Gentamicin and tobramycin have similar antimicrobial spectra against gram-negative bacilli, but tobramycin is more active against P. aeruginosa, and gentamici is more active against Serratia marcescens. Amikacin is frequently active against gentamicin and tobramycin-resistant pathogens.
Aminoglycoside antibiotics (AA) are drugs with a narrow therapeutic window and cause severe and often irreversible side effects. They are often used in combination with other antibiotics to treat serious infections caused by aerobic Gram-negative rods…. A limitation in the use of AA is the othotoxicity and nephrotoxicity.”