Aminoglycosides sepsis

The aminoglycosides include streptomycin, neomycin, kanamycin, amikacin, gentamicin, tobramycin, sisomicin, netilmicin, and others. They are used most widely against gram-negative enteric bacteria, especially in bacteremia and sepsis, in combination with vancomycin or a penicillin for endocarditis, and for treatment of tuberculosis. 

Paul M et al Beta lactam monotherapy versus beta lactam-aminoglycoside combination therapy for sepsis in immunocompetent patients Systematic review and meta-analysis of randomised trials. BM3 2004 328 668. [PMID 14996699]... 

Lang E, Schmid J, Fauser AA. A clinical trial on efficacy and safety of teicoplanin in combination with beta-lactams and aminoglycosides in the treatment of severe sepsis of patients undergoing allogeneic/autologous bone marrow transplantation. Br J Haematol 1990 76(Suppl 2) 14-18. 

Sepsis is the most frequent cause of AKI in intensive care units [78,79]. Moreover, when sepsis is associated with AKI the mortality increases dramatically [78]. The incidence of AKI increases even further in patients with septic shock. Also, the use of nephrotoxins e.g. aminoglycosides,, amphotericin B in septic patients may precipitate or worsen the AKI. 

In sepsis, double antipseudomonal coverage should be considered (e.g., addition of aminoglycoside). 

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