Aminoglycosides
It is not the end for aminoglycosides, but rather, the challenges faced by researchers have led to ingenuity and a change in how we view this class of compounds, a renaissance - Jacob L. Houghton

image by: Naveed Muhammad
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Back to the Future: Using Aminoglycosides Again and How to Dose Them Optimally
Gram-negative organisms have become increasingly resistant to both β-lactam antibiotics and fluoroquinolones. Consequently, aminoglycoside antibiotics have undergone a resurgence in use. Because of the known toxicities of aminoglycoside antibiotics, clinicians have avoided their use, unless no other alternatives were extant. Over the past 2 decades, we have learned much about the relationship between aminoglycoside exposure and the likelihood of a good clinical outcome or the occurrence of nephrotoxicity.
Resources
An antibiotic that exploits evolutionary history
Aminoglycosides attach to the part of the bacterial ribosome that decodes messages from the DNA. By blocking protein synthesis, aminoglycosides prevent the bacterium from reproducing and carrying out its basic functions. Luckily for us, our own eukaryotic ribosomes accumulated just enough differences from bacterial ribosomes that aminoglycosides cannot attach to them and block the functioning of our own cells. That means that aminoglycosides attack bacteria in our bodies but not the ribosomes of our own cells — with one exception.
Aminoglycoside Revival: Review of a Historically Important Class of Antimicrobials Undergoing Rejuvenation
Aminoglycosides are cidal inhibitors of bacterial protein synthesis that have been utilized for the treatment of serious bacterial infections for almost 80 years. There have been approximately 15 members of this class approved worldwide for the treatment of a variety of infections, many serious and life threatening. While aminoglycoside use declined due to the introduction of other antibiotic classes such as cephalosporins, fluoroquinolones, and carbapenems, there has been a resurgence of interest in the class as multidrug-resistant pathogens have spread globally.
Aminoglycoside Therapy in Neonates: With Particular Reference to Gentamicin
Aminoglycosides are among the most frequently used antibiotics in neonatology, usually for patients in whom sepsis is suspected. Despite the development of third- and fourth-generation cephalosporins and other new antibiotics, gentamicin, netilmicin, tobramycin, and amikacin continue to be important tools for treating serious infections in neonates. They are bactericidal, have a relatively low rate of bacterial resistance, and have a low cost.
Aminoglycosides: A Practical Review
Aminoglycosides are potent bactericidal antibiotics that act by creating fissures in the outer membrane of the bacterial cell. They are particularly active against aerobic, gram-negative bacteria and act synergistically against certain gram-positive organisms. Gentamicin is the most commonly used aminoglycoside, but amikacin may be particularly effective against resistant organisms.
Aminoglycosides: An Overview
Aminoglycosides are natural or semisynthetic antibiotics derived from actinomycetes. They were among the first antibiotics to be introduced for routine clinical use and several examples have been approved for use in humans. They found widespread use as first-line agents in the early days of antimicrobial chemotherapy, but were eventually replaced in the 1980s with cephalosporins, carbapenems, and fluoroquinolones
Peds - What do I need to know about aminoglycoside antibiotics?
The aminoglycosides are broad-spectrum, bactericidal antibiotics that are commonly prescribed for children, primarily for infections caused by Gram-negative pathogens. The aminoglycosides include gentamicin, amikacin, tobramycin, neomycin, and streptomycin. Gentamicin is the most commonly used antibiotic in UK neonatal units.
Pros and Cons of aminoglycosides
Maximize peak to increase efficacy and reduce toxicity. Administer once-a-day
The Complete (but Practical) Guide to Aminoglycosides
Aminoglycosides are bacterial protein synthesis inhibitors. And they do this by binding to the 30S and 50S subunits of bacterial ribosomes. I know, I know, I’m taking you way back to first year biochemistry, but bear with me
The Future of Aminoglycosides: The End or Renaissance?
Since the 1940s toxicity, resistance, and complex chemical syntheses have been associated with the use of aminoglycosides as antibacterials and antivirals. However, aminoglycosides have regrouped and are ready for a rematch.
Back to the Future: Using Aminoglycosides Again and How to Dose Them Optimally
Aminoglycosides were widely used in empirical therapy throughout the 1970s and much of the 1980s. Unfortunately, aminoglycoside use generates a number of toxicities, mostly oto- and nephrotoxicity. In summary, aminoglycosides are undergoing a resurgence in use because of widespread resistance to other therapeutic classes.
StatPearls
While aminoglycosides are an older class of medication, they continue to be clinically valuable. Aminoglycosides have a broad spectrum of activity covering aerobic organisms, including gram-negative bacteria and mycobacteria. There are several drugs within the aminoglycoside class, including gentamicin, tobramycin, amikacin, neomycin, plazomicin, and streptomycin...

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