Aminoglycosides

Question 1

Name the aminoglycosides

Answer 1

• ANGST -

Amikacin
Neomycin 
Gentamicin 
Streptomycin 
Tobramycin

Question 2

Which of the aminoglycosides are active agains Pseudomonas aeruginosa?

Answer 2

Tobramycin
Amikacin
Gentamicin

Question 3

Which of the aminoglyosides are active against Mycobacterium tuberculosis?

Answer 3

Streptomycin

Question 4

How are aminoglycosides given for systemic infections?

Answer 4

By injection, as they are not absorbed from the gut.

Question 5

What is the aminoglycoside of choice in the UK?

Answer 5

Gentamicin

Question 6

When used for the blind therapy of undiagnosed serious infections what is gentamicin given in conjunction with?

Answer 6

Penicillin or metronidazole (or both)

Question 7

Alternative to gentamicin in gentamicin-resistant enterococcal endocarditis.

Answer 7

Streptomycin

Question 8

How are loading and maintenance doses of gentamicin calculated?

Answer 8

On the basis of the patient’s weight and renal function.

Question 9

How long should Gentamicin treatment last?

Answer 9

whenever possible it should not exceed 7 days

Question 10

What is more stable than Gentamicin?

Answer 10

Amikacin

Used in the treatment of serious infections caused by gentamicin-resistant Gram-negative bacilli

Question 11

Which has similar activity to Gentamicin?

Answer 11

Tobramycin
however it is slightly more active against Ps. aeruginosa but shows less activity against certain other Gram-negative bacteria.

Question 12

How can Tobramycin be administered in treatment of chronic pulmonary Ps. aeruginosa infection in CF?

Answer 12

By Nebuliser or by inhalation powder on a cyclical basis (28 says of tobramycin followed by a 28 day tobramycin-free interval)

Question 13

Can Neomycin be injected (parenteral administration)?

Answer 13

NO it’s too toxic.
I can only be used for infections of the skin or mucous membranes or to reduce the bacterial population of the colon prior to bowel surgery or in hepatic failure.

Question 14

Is once daily dosage of aminoglycosides possible?

Answer 14

Yes,
its more convenient and provides adequate serum concentrations.

Should be avoided in patients with endocarditis due to gram-positive bacteria, HACEK endocarditis, burns of more than 20% of the total body surface area, or CrCl less than 20 ml/min.

Not recommended in pregnancy

Question 15

Monitoring requirements

Answer 15

Serum Concentrations
SHOULD: in all patients
MUST: in elderly, in obesity, in cystic fibrosis, if high doses are given and in renal impairment