Systemic Aminoglycosides

• Streptomycin
• Gentamicin
• Kanamycin
• Tobramycin

• Amikacin
• Sisomicin
• Netilmicin
• Paromomycin

Topical Aminoglycosides

• Neomycin

• Framycetin

Drug

Dosage

MOA

ADR

USES

Aminoglycoside (Overall)



• Transport of aminoglycoside through bacterial cell wall and cytoplasmic membrane
• Binding to ribosome resulting in inhibition of protein synthesis
• Once inside cell Streptomycin binds to 30s ribosome
• But other aminoglycoside bind to additional sites on 50s subunit as well as to 30s-50s interface
• They freeze initiation of protein

synthesis

• Ototoxicity- Chochlear damage, vestibular damage
• Nephrotoxicity
• NM blockade- reduce release of ACh from motor nerve endings



Gentamicin



• Same as above



• RTI in critically ill patients and in those with impaired host resistance
• Pseudomonas, Proteus or Klebsiella infections- Burns, UTI, Pneumonia, Lung abscess, Osteomyelitis, Middle ear infections, Septicaemia
• Meningitis
• SABE

Drug

Dosage

MOA

ADR

USES

Streptomycin



• Same as above

• Vestibular disturbances
• Lowest nephrotoxicity amongst AGs
• Hypersensitivity
• Topical use contraindicated for fear of contact sensitization

• TB
• SABE
• Plague
• Tularemia

Neomycin





• Topical use- low sensitizing potential, however rash can occur
• Oral- damages villi, malabsorption syndrome with diarrhea and steatorrhea

• Topically for infected wound, ulcer, burn, external ear infections, conjunctivitis
• Orally- bowel preparation before surgery
• Hepatic coma