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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GENTAMICIN LEVELS IN DIAGNOSTIC ASPIRATES FROM PATIENTS WITH HIP AND KNEE ARTROPLASTY
From Journal of Bone and Joint Surgery, 1/1/04 by Fletcher, M D A

Joint fluids obtained for diagnostic purposes from 25 patients were assayed for the presence of gentamicin. All of the patients had presented with failing or painful joints at periods up to 10 years following primary hip or knee arthroplasty using gentamicin-impregnated cement. Gentamicin was detected in the joint fluids from 9 of 15 patients with knee prostheses and 4 of 10 with hip prostheses. Gentamicin concentrations ranged from 0.06mg/L to 0.85 mg/L with no significant differences in concentration between patients with hip or knee prostheses, or type of prosthesis, and no identifiable relationship was found gentamicin concentration and the time after primary arthroplasty. Although the majority of the gentamicin concentrations were found to be below the levels required to inhibit susceptible pathogens, we conclude that gentamicin release around failing implants may lead to false negative cultures in some patients and provide selective pressure for the emergence of resistance where infection is present in others.

MDA Fletcher. R F Spencer. V G Langkamer, A M Lovering

Soiithmead Hospital, Bristol

Copyright British Editorial Society of Bone & Joint Surgery 2004
Provided by ProQuest Information and Learning Company. All rights Reserved

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