DefinitionThis section has been translated automatically.
A bactericidal, easily water-soluble antibiotic complex from the group of aminoglycosides, extracted from cultures of Micromonospora purpurea and M. echinospora. Gentamicin is used as a sulphate salt for bacterial infections. The active ingredient contains several very similar fractions C1 (25-35%), C1a (20-31%) and C2 (40-45%).
The basic structure of all aminoglycosides consists of a central hexose core, which is glycosidically linked to 2 amino sugars. Aminoglycosides carry free OH and NH2 groups: the OH groups make the mixture hydrophilic. The NH2 groups give the mixture slightly basic and nucleophilic properties in neutral and alkaline environments.
Half-lifeThis section has been translated automatically.
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Pharmacodynamics (Effect)This section has been translated automatically.
Gentamicin has a bactericidal effect by binding to the 30s subunit of the bacterial ribosome, preventing the reading of mRNA and thus inhibiting protein biosynthesis. In high doses gentamicin has a cytotoxic effect.
Spectrum of actionThis section has been translated automatically.
Gentamicin is mainly effective against Gram-negative bacteria, including problem germs. Gentamicin is used against the following germs: Staphylococci, Enterobacter aerogens, Pseudomonas aeruginosa, Haemophilus influenzae, Escherichia coli, Proteus mirabilis, Klebsiella, Gonococci, Salmonella.
Field of application/useThis section has been translated automatically.
Systemic use: Gentamicin has a relatively narrow therapeutic range.
Topical applications: Gentamicin-containing topicals are offered in ophthalmology and dermatology. Its use in wound treatment no longer appears to be necessary as there is a strong problem of resistance.
Gentamicin is used as an implantable chain (Septopal®) in infected bones and soft tissue. It is also used as a component of bone cement in joint implants.
IndicationThis section has been translated automatically.
Indications are severe and most severe infections that cannot be controlled by other (better tolerated antibiotics), e.g.:
Severe respiratory tract, urinary tract and soft tissue infections; severe intra-abdominal infections, sepsis, meningitis, endocarditis, infections of the eye with threatening ophthalmia.
Gentamicin should always be used in combination with a betalactam antibiotic (e.g. piperacillin). A combination with ampicillin is considered the standard therapy for listeria meningitis.
Dosage and method of useThis section has been translated automatically.
- Systemic: The initial dose in adults is 120 mg or 1.5-2 mg/kgkgKG, regardless of kidney function. Maintenance dose: 1-2mg/kgkgkgkg every 8h. In case of renal insufficiency the dose is reduced accordingly.
- Topical skin: Cream/powder (0.1-0.2%): Apply thinly 2-3 times/day in the area of the affected skin areas.
- Topical conjunctiva: Eye drops/ointment (0.5%): Apply 1 trp. 4-6 times/day or 0.5-1 cm ointment into the conjunctival sac.
Remember! Topical application only if there is no therapeutic alternative! Max. Therapy duration: 14 days.
Undesirable effectsThis section has been translated automatically.
Topical application: Irritations, sensitization.
Systemic: Gentamicin is ototoxic (in 1-3 % of cases) and nephrotoxic. In the inner ear, depending on the concentration, it can lead to balance disorders (up to 14 %) and hearing loss.
The multi-organ toxicity limits the use of this antibiotic to severe, mostly nosocomial infections. Serum levels should be monitored (max. 15-20 mg/l), especially in problem cases (e.g. in newborns).
Recipe(s)This section has been translated automatically.
PreparationsThis section has been translated automatically.
Note(s)This section has been translated automatically.
If aminoglycoside antibiotics are obtained from Streptomyces species, a "y" is inserted in the name extension (-ycin). If aminoglycoside antibiotics are obtained from Micromonospora species, an "i" is inserted in the suffix (-icin) (gentamicin)
LiteratureThis section has been translated automatically.
- Baltch AL et al (2007) Antimicrobial Activities of Daptomycin, Vancomycin, and Oxacillin in Human Monocytes and of Daptomycin in Combination with Gentamicin and/or Rifampin in Human Monocytes and in Broth against Staphylococcus aureus. Antimicrobial agents Chemother 51: 1559-1562