Aminoglycosides

Summary

Aminoglycosides include the drugs neomycin, gentamicin, amikacin, streptomycin, and tobramycin. Aminoglycosides are a class of antibiotics that are used to kill gram negative bacteria. The two biggest side effects are ototoxicity and nephrotoxicity. As the nurse, you will want to closely monitor the patient’s hearing, as well as their kidney function through BUN, creatinine, and urine output levels.

Key Points

• Aminoglycosides
  • Key Drugs
    • Gentamicin
    • Amikacin
    • Tobramycin
    • Streptomycin
    • Neomycin
  • Mechanism
    • Antibiotic
      • Gram negative bacteria
      • Inhibit bacterial cell wall synthesis
      • Peak and trough levels should be monitored
      • Cannot be given PO as it is not absorbed well through the GI tract. Will usually be given IV or IM.
  • Clinical Use
    • Severe Bacterial Infections
      • MRSA
      • E. Coli
      • Respiratory infections
      • Urinary tract infections
      • Skin infections
      • Systemic infections like bacteremia
  • Side Effects and Adverse Reactions
    • Ototoxicity
      • Immediately report hearing or balance problems
      • Presents as tinnitus, vertigo, and hearing loss
      • A baseline hearing test is recommended
      • Concurrent use of other ototoxic drugs like loop diuretics increase the risk for ototoxicity
    • Nephrotoxicity
      • Closely monitor creatinine levels, urinary output, and BUN
      • Can present as proteinuria
    • Superinfection
      • e.g. C. difficile overgrowth