AMINOGLYCOSIDES (Systemic)
Some commonly used brand names are:
In the U.S.?
- Amikin 1
- Garamycin 2
- G-Mycin 2
- Jenamicin 2
- Kantrex 3
- Nebcin 7
- Netromycin 5
In Canada?
- Amikin 1
- Garamycin 2
- Nebcin 7
- Netromycin 5
Note: | For quick reference, the following aminoglycosides are numbered tomatch the corresponding brand names. |
Category
- Antibacterial, antimycobacterial?Streptomycin
- Antibacterial, systemic?Amikacin; Gentamicin; Kanamycin; Netilmicin; Streptomycin; Tobramycin
Description
Aminoglycosides (a-mee-noe-GLYE-koe-sides) are used to treat serious bacterial infections. They workby killing bacteria or preventing their growth.
Aminoglycosides are given by injection to treat serious bacterial infectionsin many different parts of the body. In addition, some aminoglycosides maybe given by irrigation (applying a solution of the medicine to the skin ormucous membranes or washing out a body cavity) or by inhalation into the lungs.Streptomycin may also be given for tuberculosis (TB). These medicines maybe given with 1 or more other medicines for bacterial infections, or theymay be given alone. Aminoglycosides may also be used for other conditionsas determined by your doctor. However, aminoglycosides will not work for colds,flu, or other virus infections.
Aminoglycosides given by injection are usually used for serious bacterialinfections for which other medicines may not work. However, aminoglycosidesmay also cause some serious side effects, including damage to your hearing,sense of balance, and kidneys. These side effects may be more likely to occurin elderly patients and newborn infants. You and yourdoctor should talk about the good these medicines may do as well as the risksof receiving them.
Aminoglycosides are to be administered only by or under the immediate supervisionof your doctor. They are available in the following dosage forms:
Inhalation- Amikacin
- Inhalation solution (U.S.)
- Gentamicin
- Inhalation solution (U.S.)
- Kanamycin
- Inhalation solution (U.S.)
- Tobramycin
- Inhalation solution (U.S.)
Irrigation- Kanamycin
- Irrigation solution (U.S.)
Parenteral- Amikacin
- Injection (U.S. and Canada)
- Gentamicin
- Injection (U.S. and Canada)
- Kanamycin
- Neomycin
- Netilmicin
- Injection (U.S. and Canada)
- Streptomycin
- Injection (U.S. and Canada)
- Tobramycin
- Injection (U.S. and Canada)
Before Receiving This Medicine
In deciding to use a medicine, the risks of taking the medicine must beweighed against the good it will do. This is a decision you and your doctorwill make. For aminoglycosides, the following should be considered:
Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to any of the aminoglycosides. Also tell your health careprofessional if you are allergic to any other substances, such as foods, sulfites,or other preservatives.
Pregnancy?Studies on most of the aminoglycosides have not beendone in pregnant women. Some reports have shown that aminoglycosides, especiallystreptomycin and tobramycin, may cause damage to the infant's hearing, senseof balance, and kidneys if the mother was receiving the medicine during pregnancy.However, this medicine may be needed in serious diseases or other situationsthat threaten the mother's life. Be sure you have discussed this with yourdoctor.
Breast-feeding?Aminoglycosides pass into breast milk in smallamounts. However, they are not absorbed very much when taken by mouth. Todate, aminoglycosides have not been reported to cause problems in nursingbabies.
Children?Children are especially sensitive to the effectsof aminoglycosides. Damage to hearing, sense of balance, and kidneys is morelikely to occur in premature infants and neonates.
Older adults?Elderly people are especially sensitive to the effectsof aminoglycosides. Serious side effects, such as damage to hearing, senseof balance, and kidneys may occur in elderly patients.
Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. When you are receivingaminoglycosides it is especially important that your health care professionalknows if you are taking any of the following:
- Aminoglycosides, used on the skin or mucous membranes and by injectionat the same time; or more than one aminoglycoside at a time or
- Anti-infectives by mouth or by injection (medicine for infection)or
- Capreomycin (e.g., Capastat) or
- Carmustine (e.g., BiCNU) or
- Chloroquine (e.g., Aralen) or
- Cisplatin (e.g., Platinol) or
- Combination pain medicine containing acetaminophen and aspirin (e.g.,Excedrin) or other salicylates (with large amounts taken regularly) or
- Cyclosporine (e.g., Sandimmune) or
- Deferoxamine (e.g., Desferal) (with long-term use) or
- Gold salts (medicine for arthritis) or
- Hydroxychloroquine (e.g., Plaquenil) or
- Inflammation or pain medicine, except narcotics, or
- Lithium (e.g., Lithane) or
- Methotrexate (e.g., Mexate) or
- Penicillamine (e.g., Cuprimine) or
- Plicamycin (e.g., Mithracin) or
- Quinine (e.g., Quinamm) or
- Streptozocin (e.g., Zanosar) or
- Tiopronin (e.g., Thiola)?Use of any of these medicines withaminoglycosides may increase the chance of hearing, balance, or kidney sideeffects.
Other medical problems?The presence of other medicalproblems may affect the use of the aminoglycosides. Make sure you tell yourdoctor if you have any other medical problems, especially:
- Kidney disease?Patients with kidney disease may have increasedaminoglycoside blood levels and increased chance of side effects
- Loss of hearing and/or balance (eighth-cranial-nerve disease)?Highaminoglycoside blood levels may cause hearing loss or balance disturbances
- Myasthenia gravis or
- Parkinson's disease?Aminoglycosides may cause muscular problems,resulting in further muscle weakness
Proper Use of This Medicine
To help clearup your infection completely, aminoglycosides must begiven for the full time of treatment, even if you begin to feel betterafter a few days. Also, this medicine works best when there is a certain amountin the blood or urine. To help keep the correct level, aminoglycosides mustbe given on a regular schedule.
Dosing?The dose of aminoglycosides will be differentfor different patients. Follow your doctor's orders orthe directions on the label. The following information includes onlythe average doses of aminoglycosides. Your dose may be different if you havekidney disease. If your dose is different, do not changeit unless your doctor tells you to do so.
The dose of most aminoglycosides is based on body weight and must be determinedby your doctor. The medicine is injected into a muscle or vein. Dependingon the aminoglycoside prescribed, doses are given at different times and fordifferent lengths of time. These times are as follows:
For amikacin- For all dosage forms:
- Adults and children: The dose is given every eight or twelve hoursfor seven to ten days.
- Newborn babies: The dose is given every twelve hours for seven toten days.
- Premature babies: The dose is given every eighteen to twenty-fourhours for seven to ten days.
For gentamicin- For all dosage forms:
- Adults and children: The dose is given every eight hours for sevento ten days or more.
- Infants: The dose is given every eight to sixteen hours for sevento ten days or more.
- Premature and full-term newborn babies: The dose is given every twelveto twenty-four hours for seven to ten days or more.
For kanamicin- For all dosage forms:
- Adults and children: The dose is given every eight or twelve hoursfor seven to ten days.
For netilmicin- For all dosage forms:
- Adults and children: The dose is given every eight or twelve hoursfor seven to fourteen days.
For streptomycin- For all dosage forms?The dose ofstreptomycin is often not based on body weight and the amount given dependson the disease being treated.
- Treatment of tuberculosis (TB):
- Adults: Dose is based on body weight and must be determined by yourdoctor. This dose is injected into a muscle. The dosing schedule will alsobe determined by your doctor, usually once daily or twice weekly or threetimes-a-week. This medicine must be given with other medicines for tuberculosis(TB).
- Children and adolescents: Dose is based on body weight and must bedetermined by your doctor. This dose is injected into a muscle. The dosingschedule will also be determined by your doctor, usually once daily or twiceweekly or three times-a-week. This medicine must be given with other medicinesfor tuberculosis (TB).
- Treatment of bacterial infections:
- Adults: 250 to 500 milligrams of streptomycin is injected into amuscle every six hours; or 500 milligrams to 1 gram of streptomycin is injectedinto a muscle every twelve hours.
- Children and adolescents: Dose is based on body weight and must bedetermined by your doctor. This dose is injected into a muscle every six totwelve hours.
For tobramycin- For all dosage forms:
- Adults and adolescents: The dose is given every six to eight hoursfor seven to ten days or more.
- Older infants and children: The dose is given every six to sixteenhours.
- Premature and full-term newborn babies: The dose is given every twelveto twenty-four hours.
Side Effects of This Medicine
Along withits needed effects, a medicine may cause some unwanted effects. Although notall of these side effects may occur, if they do occur they may need medicalattention.
Check with your healthcare professional immediately if any of the following side effectsoccur:
More common
Any loss of hearing; clumsiness or unsteadiness; dizziness; greatly increasedor decreased frequency of urination or amount of urine; increased thirst; loss of appetite; nausea or vomiting; numbness, tingling,or burning of face or mouth (streptomycin only); muscle twitching, or convulsions (seizures); ringingor buzzing or a feeling of fullness in the ears
Difficulty in breathing; drowsiness; weakness
In addition, leg cramps, skin rash,fever, and convulsions (seizures) may occur when gentamicin is given by injectioninto the muscle or a vein, and into the spinal fluid.
For up to several weeks after you stop receiving thismedicine, it may still cause some side effects that need medical attention.Check with your doctor if you notice any of the following side effects orif they get worse:
Any loss of hearing; clumsiness orunsteadiness; dizziness; greatly increased or decreased frequency of urination or amount of urine; increased thirst; lossof appetite; nausea or vomiting; ringing or buzzing or a feeling of fullness in the ears
Other side effects not listed above may also occur in some patients. Ifyou notice any other effects, check with your doctor.
Revised: 09/11/2002
