Aminoglycosides clinical presentation

In the vestibnlar organ, the initial hair cell damage occurs in the apex of the cristae and the striolar regions of the maculi. Hair cell loss then progresses toward the periphery of the vestibular receptor organ with type I hair cells affected earlier than the type 11 hair cells. Vestibular disturbances from systemic aminoglycoside administration present as severe unsteadiness that becomes worse in the dark, bnt an objective clinical assessment is difficult. In contrast to the situation in the cochlea, regeneration of vestibular hair cells has been observed in mammalian species. ... 

More recent studies have shown that a novel hepta-acylated lipid A (m/z 1855, Fig. 11.2c) is present in a subset of clinical isolates from patients with severe CF pulmonary disease. Formation of hepta-acylated lipid A results from loss of an enzymatic activity (PogL) that ordinarily deacylates the 3-position of the diglucosamine backbone. Retention of this fatty acid at this position is associated with enhanced resistance to i-lactam antibiotics but not to aminoglycosides. 

This chapter covers the aminoglycosides used in present clinical practice. Most of these molecules have been introduced between the mid-60 s and the early 80 s (gentamicin, tobramycin, dibekacin, amikacin, netilmicin). Since then, only isepamicin and arbeka-cin have been developed and brought to market in only a few countries. Aminoglycoside antibiotics have important antibacterial properties. They demonstrate con-... 

Benveniste R, Davies J. Aminoglycoside antibiotic inactivating enzymes in actinomycetes similar to those present in clinical isolates of arttibiotic resistant bacteria. Proc Natl Acad... 

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