Classification
Gentamycin belongs to the group of aminoglycosides. A distinction is made between aminoclycosides with a general indication, to which gentamycin, tobramycin and amikacin belong, and aminoglycosides with a specific indication. Gentamycin is also known under the trade name RefobacinR.
Effect
Aminoglycosides also inhibit bacterial growth by inhibiting the protein biosynthesis of the bacterial cell.
Fields of application
Gentamycin is a broad-spectrum antibiotic that covers the germs E. coli, Klebsiellen, Proteus vulgaris and Pseudomonas aeroginosa in the gram-negative range and staphylococci in the gram-positive range. Against Streptococci, Haemophilus and Anaerobes (Bacteroides, Clostridia) it is not or only weakly effective. The main areas of application are severe infections, such as pneumonia, urinary tract infections, endocarditis, blood poisoning (sepsis), infected wounds, eye infections, bone and soft tissue infections.
Gentamycin is also found in antibiotic eye drops or eye ointments. However, here it is used for external application. Dexa-gentamicin eye drops are often used to treat inflammation caused by gentamicin-sensitive pathogens.
Side effects
Aminoglycosides are quite rich in side effects. They can be deposited in the kidneys and cause damage (nephrotoxic) there. However, the kidney damage is reduced by corresponding regeneration of the cells after the drug has been discontinued.
A pathological urine picture may occur, which contains so-called cylinders, cells and protein. Furthermore, aminoglycosides can have ear-damaging effects through accumulation in the so-called perilymph of the ear. This impairment can also be regressive.
Only in cases of severe damage to the ear does the hearing loss persist even after the drug is discontinued. Especially if the dose is too high, if the drug is used for too long or if the kidney insufficiency is not taken into account, balance problems and dizziness may occur. Since aminoglycosides accumulate in the tissue, there is a risk that the side effects will continue to occur even after the drug is discontinued.
In addition to allergies and blood formation disorders, the danger of nerve damage (neurotoxicity), which can extend to respiratory paralysis, should also be mentioned. Especially a combination with anaesthetics and citrate blood could increase a neurotoxic effect. In order to minimize the numerous side effects, a dose adjustment should be made in the case of kidney function impairment. A so-called drug monitoring with recording of daily drug levels is also helpful. Gentamycin should be given as a short infusion once a day for one hour to avoid overdose and to minimize the side effects.
