antibioticsbooks

104 PART 2 Antibacterial Drugs
by safer and more effective first-line drugs. It
is still an alternative in resistant tuberculosis
infections—these should be treated by an
expert in their management.
What They’re Good For
In combination with a beta-lactam agent, treatment
of serious infections with documented or
suspected Gram-negative pathogens, including
febrile neutropenia, sepsis, exacerbations of cystic
fibrosis, and ventilator-associated pneumonia.
Aminoglycosides, primarily gentamicin, are also
used in combination with a beta-lactam or glycopeptide
for treatment of serious Gram-positive infections,
including endocarditis, osteomyelitis, and
sepsis. In combination with other antimycobacterials,
they are used for treatment of drug- resistant
infections with Mycobacterium tuberculosis or
other mycobacteria ( streptomycin and amikacin).
Don’t Forget!
Most aminoglycoside toxicity is dose related, so
get the dose right from the start by adjusting for
renal dysfunction and using ideal or adjusted body
weight. Pharmacokinetic concentrations are useful
for monitoring and dosing aminoglycosides if they
are drawn correctly.