Interventions for Tuberculosis Control and Elimination 2002
Interventions for Tuberculosis Control and Elimination 2002
Interventions for Tuberculosis Control and Elimination 2002
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Like other aminoglycosides, amikacin affects the neuromuscular junction<br />
<strong>and</strong> may lead to neuromuscular blockade, 409,410,991 an effect that may<br />
be reduced by lithium, 992 but not reversed by neostigmine.<br />
Indomethacin may interact with amikacin in newborns by increasing<br />
serum levels to toxic concentrations. 993 Neurotoxicity might be increased<br />
by muscle relaxants such as tubocourarine, succinylcholine or decamethonium.<br />
Kanamycin<br />
Kanamycin was isolated from Streptomyces kanamyceticus by Umezawa<br />
<strong>and</strong> collaborators in 1957. 994 It is a mixture of kanamycin A, B, <strong>and</strong> C. 995-997<br />
Kanamycin is active against a range of gram-negative bacteria <strong>and</strong><br />
mycobacteria including M. tuberculosis. 998<br />
Kanamycin is not absorbed orally, but intramuscular administration<br />
leads to peak serum levels within an hour <strong>and</strong> the serum half-life is about<br />
four to six hours. 998 It is mainly excreted through the kidneys <strong>and</strong> thus,<br />
as with all aminoglycosides, dose adjustments are warranted in patients with<br />
renal failure. 998<br />
The usual dosage of kanamycin is 0.5 g to 1 g per day. 998<br />
Similar to other aminoglycosides, eighth cranial nerve toxicity is the<br />
most important. Auditory toxicity is more pronounced than vestibular toxicity<br />
998 <strong>and</strong> is very frequent, affecting up to 20% of patients after three<br />
months, <strong>and</strong> up to 60% if treatment lasts <strong>for</strong> six months. 999 Like other<br />
aminoglycosides, kanamycin may cause neuromuscular blockade. 409 Other<br />
adverse drug events include renal toxicity <strong>and</strong>, rarely, allergies. 998<br />
As with other aminoglycosides, resistance is thought to be acquired<br />
through a single extrachromosomal plasmid factor with multi-step selection.<br />
1000 Capreomycin resistant strains are not usually resistant to<br />
kanamycin. 476 The inverse seems to be the case <strong>for</strong> low, but not <strong>for</strong> high<br />
kanamycin resistance. 476<br />
Capreomycin<br />
Capreomycin, a polypeptide antibiotic, was isolated from Streptomyces capreolus<br />
by Herr <strong>and</strong> collaborators at the Lilly Research Laboratories in 1959. 1001<br />
Capreomycin is active against various species of mycobacteria, including<br />
M. tuberculosis. 1002,1003<br />
154
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