title: What do I need to know about aminoglycoside antibiotics?
abstract: The aminoglycosides are broad-spectrum, bactericidal antibiotics that are commonly prescribed for children, primarily for infections caused by Gram-negative pathogens. The aminoglycosides include gentamicin, amikacin, tobramycin, neomycin, and streptomycin. Gentamicin is the most commonly used antibiotic in UK neonatal units. Aminoglycosides are polar drugs, with poor gastrointestinal absorption, so intravenous or intramuscular administration is needed. They are excreted renally. Aminoglycosides are concentration-dependent antibiotics, meaning that the ratio of the peak concentration to the minimum inhibitory concentration of the pathogen is the pharmacokinetic-pharmacodynamic index best linked to their antimicrobial activity and clinical efficacy. However, due to their narrow therapeutic index, the patient's renal function should be monitored to avoid toxicity, and therapeutic drug monitoring is often required. Here we provide a review of aminoglycosides, with a particular focus on gentamicin, considering their pharmacokinetics and pharmacodynamics, and also practical issues associated with prescribing these drugs in a paediatric clinical setting.
authors: Inflammation, Infection and Rheumatology Section, UCL Institute of Child Health, London, UK.
authors: Eva
authors: E
authors: Germovsek
authors: Inflammation, Infection and Rheumatology Section, UCL Institute of Child Health, London, UK.|Paediatric Infectious Diseases Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
authors: Charlotte I
authors: http://orcid.org/0000-0002-6757-5867
authors: CI
authors: Barker
authors: Paediatric Infectious Diseases Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
authors: Mike
authors: M
authors: Sharland
mesh_terms: D000617:Aminoglycosides / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000592:standards*; D008297:Male; D017410:Practice Guidelines as Topic; D006113:United Kingdom
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents
keywords: children; gentamicin; neonates; prescribing