Zbigniew Ochocki, Andrzej Stańczak
Aminoglycosides. Aminoglycosides are potent bactericidal antibiotics that act by creating fissures in the outer membrane of the bacterial cell and work by binding to the bacterial 30S ribosomal subunit, causing misreading of tRNA, leaving the bacterium unable to synthesize proteins vital to its growth. They are particularly active against aerobic, gram-negative bacteria and act synergistically against certain gram-positive organisms. They include amikacin, gentamicin, kanamycin, neomycin, netilmicin, paromomycin, streptomycin, and tobramycin. Aminoglycosides are useful primarily in infections involving aerobic, Gram-negative bacteria, such as Pseudomonas, Acinetobacter, and Enterobacter. In addition, some mycobacteria, including the bacteria that cause tuberculosis, are susceptible to aminoglycosides. Streptomycin was the first effective drug in the treatment of tuberculosis. Gentamicin is the most commonly used aminoglycoside, but amikacin may be particularly effective against resistant organisms. Aminoglycosides are used in the treatment of severe infections of the abdomen and urinary tract, as well as bacteremia and endocarditis. They are also used for prophylaxis, especially against endocarditis. Resistance is rare but increasing in frequency. Other aminoglycosides were subsequently developed, including amikacin, netilmicin and tobramycin, which are all currently available for systemic use in the clinical practice.