Aminoglycosides

Key points


General

Pharmacodynamics

Beneficial actions and effects

Resistance (by bacteria)

Adverse effects

Pharmacokinetics


Available agents

Gentamicin

  • most widely used (vet med) injectable
  • pulse dose or monitor concentrations
    • pulse dose likely safe for all adults (even mild renal failure)
    • 24 hour interval may still be too short for some neonates
    • Target peak (> 10 µg/ml)
    • Target trough (< 1 µg/ml)
gentamicin

Amikacin

  • resistant to most bacterial enzymes (less resistance)
  • increased cost v. gentamicin
  • Same pulse dose v monitoring concerns
    • Target peak (> 35 µg/ml)
    • Target trough (< 4 µg/ml)
amikacin USP

Nneomycin

  • veterinary use almost exclusively oral
  • very little systemic absorption (though still enough to create residues)
neomycin oral solution

Tobramycin

  • spectrum equivalent to gentamicin
  • most use will be ophtalmic (topical)
tobramycin ophthalmic solution

Kanamycin

  • spectrum equivalent to gentamicin
  • less is known about monitoring v. pulse dosing.
kanamycin, usp