A resource of Calculate by QxMD at https://www.qxmd.com/calculate
Over 400 decision support tools available • get the app for iOS or Android at qx.md/calculate
Aminoglycoside antimicrobial agents are highly potent, bactericidal antibiotics effective against multiple Gramnegative, and selected Gram-positive bacterial pathogens when administered with beta-lactams and other cell-wall active antimicrobial agents.267-269 Progressive antimicrobial resistance to other antimicrobial agents and lack of new alternatives to aminoglycoside antibiotics have caused a recent increase in their use. Aminoglycosides have many favorable attributes, including their remarkable stability, predictable pharmacokinetics, low incidence of immunologically mediated side-effects, and lack of hematologic or hepatic toxicity. Nephrotoxicity, and to a lesser degree ototoxicity and neuromuscular blockade, continue to be the major dose-limiting toxicities of the aminoglycosides. Careful dosing and therapeutic drug monitoring of aminoglycosides using pharmacokinetic and pharmacodynamic principles can mitigate the risk of AKI with these clinically useful, yet nephrotoxic antibiotics.270 A number of metaanalyses and treatment guidelines have been published recently indicating that the risk of AKI attributable to aminoglycosides is sufficiently frequent that they should no longer be added to other standard antimicrobial agents for the empirical or directed treatment of a number of severe Gram-positive or Gram-negative bacterial infections.271-276 The intrinsic risk of AKI with the administration of aminoglycosides has led some authors to call for elimination of aminoglycosides as a therapeutic option in current clinical management of infectious diseases.277 The anticipated demise of aminoglycosides from our therapeutic armamentarium has not occurred, however, in light of recent developments with progressive antimicrobial resistance to beta-lactams, quinolones, and a number of other classes of antimicrobial agents.
Do you have an enquiry or suggestion? Get in touch with us through Twitter @QxMD, Facebook QxMD, or email contact@qxmd.com