Aminoglycosides

Aminoglycosides are a class of antibiotics that are used primarily to treat gram negative infections as well as for enterococcus species.  These medications work by interfering with the assembly and function of the 30s subunit of the ribosome, which inhibits protein synthesis. Aminoglycosides are bactericidal.  Bacterial resistance from efflux pumps, decreased uptake and enzymatic degradation can occur.  Notable adverse effects include ototoxicity and hypersensitivity.

Class Drugs

• Amikacin

• Gentamicin

• Neomycin

• Streptomycin

• Tobramycin

Class Mechanism of Action

Interferes with function/assembly of 30s subunit of ribosome (by binding to 30s subunit), inhibiting protein synthesis

Bactericidal

Class Applications

Resistant gram negatives (Pseudomonas, etc.)

Enterococcus endocarditis (used in combination with beta-lactam such as ampicillin)

Organisms treated

• Gram (+) cocci

Enterococcus sp.

• S. agalactiae

• Gram (-) rods

Acinetobacter

• Brucella

• Francisella tularensis (tularemia)

• Klebsiella

• Pseudomonas

• Yersinia pestis

Class Adverse Effects

Resistance

• Efflux pumps

Pumps decrease intracellular concentration of drug

• Enzymatic inactivation

• Decreased uptake

Hypersensitivity

• Rashes, angioedema, anaphylaxis

Ototoxicity

• May be irreversible and affects pregnancies

• Take care in combination with other ototoxic drugs (loop diuretics)

Vertigo

Neuromuscular paralysis

• Careful use in patients with myasthenia gravis

• Reversal agents

Calcium gluconate

• Neostigmine

Drug Table

Drug Name	Application	Comments	Image
Amikacin			"Amy" "K" "Sin"
Gentamicin			"Gentleman" "Sin"
Neomycin			"Neo" "Sin"
Streptomycin			"Strip" "Toe" "Sin"
Tobramycin			"Toby" "Sin"