Gentamicin
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Gentamicin

Gentamicin is a aminoglycoside antibiotic, and can treat many different types of bacterial infections, particularly Gram-negative infection. more...

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Gentamicin works by binding to a site on the bacterial ribosome, causing the genetic code to be misread.

Like all aminoglycosides, gentamicin does not pass the gastro-intestinal tract, so it can only be given intravenously, intramuscularly or topically.

Gentamicin can cause deafness or a loss of equilibrioception in genetically susceptible individuals. These individuals have a normally harmless mutation in their DNA, that allows the gentamicin to affect their cells. The cells of the ear are particularly sensitive to this. It is sometimes used intentionally for this purpose in severe Ménière’s disease, to disable the vestibular apparatus.

Gentamicin can also be highly nephrotoxic, particularly if multiple doses accumulate over a course of treatment. For this reason gentamicin is usually dosed by body weight. Various formulae exist for calculating gentamicin dosage. Also serum levels of gentamicin are monitored during treatment.

E. Coli has shown some resistance to Gentamicin, despite being Gram-negative.

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Vitamin B12 prevents gentamicin-induced ototoxicity
From Townsend Letter for Doctors and Patients, 11/1/01 by Alan R. Gaby

Guinea pigs were given a single large dose of gentamicin (125 mg/kg intramuscularly), and were randomly assigned to receive methylcobalamin (a form of vitamin B12; 1 mg/kg intramuscularly), immediately following the gentamicin, or no methylcobalamin. Electro-physiological tests of the right ear demonstrated that administration of methylcobalamin inhibited the transient ototoxic action of gentamicin.

Comment: Aminoglycoside-induced ototoxicity, which is largely irreversible, results from the progressive destruction of vestibular or cochlear cells. Although this study was done in animals and assessed only transient ototoxicity, it raises the possibility that repeated administration of vitamin B12 during a course of aminoglycoside therapy would prevent the development of permanent hearing loss or vestibular dysfunction that sometimes results from the use of these drugs. Studies in humans are warranted.

Jin X, et al. Methylcobalamin as antagonist to transient ototoxic action of gentamicin. Acta Otolaryngol 2001;121:351-354.

COPYRIGHT 2001 The Townsend Letter Group
COPYRIGHT 2001 Gale Group

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