Antibiotics: aminoglycosides polymyxin

Classes of Useful Antibacterial Antibiotics Penicillin Cephalosporin -C Steroid Aminoglycoside Polymyxin Chloramphenicol Cycloserine Tetracycline Macrolide Ansa macrolide Lincomycin Cycloserine Novobiocin... 

In addition to the penicillins and cephalosporins, many other substances with antibiotic properties are known and widely used. Substances in this group include the tetracyclines, chloramphenicol and thiamphenicol, aminoglycosides, polymyxins, rifamycins, macrolides, lincomycins, and other miscellaneous compounds. These antibiotics are used in the systemic and topical treatment of infectious diseases. Some of these antibiotics have also been used to stimulate growth in animals they may still be in use now and may therefore persist in the environment. 

Combinations of local and systemic antibiotics for selective decontamination of the digestive tract (SDD) have been advocated to reduce or prevent HAP and other nosocomial infections (108-114). The SDD often uses combinations of nonabsorbable antibiotics, such as aminoglycoside, polymyxin B, and amphotericin B in a paste, which is applied to the oropharynx, and a liquid, which is given orally, with and without systemic cefotaxime, trimethoprim, or... 

Certain antibiotics (e.g., aminoglycosides, macroUdes, polymyxins, lincomycin) enhance neuromuscular blockade by either decreasing ACh release or blocking the... 

Topical Antibiotic Monotherapy Localized impetiginized eczema lesions can be treated successfully with topical fusidic acid or mupirocin, whereas topical application of other antibiotics (neomycin as obsolete aminoglycosid, tetracyclines, or polymyxines) should be avoided.84 Especially in children with AD, fusidic acid resistance seems to be a particular problem reflecting the chronicity and the extent of the disease (see Section 30.2.2). 

Of the effective compodnds available at the present time, the )3-lactam antibiotics, the aminoglycosides and the polymyxins are all bacteriocidal. The j8-lactam antibiotics, notably carbenicillin, suffer primarily from the penetration factor but enzyme activity can play an important part. The aminoglycosides, on the other hand, have few or no penetration problems but are subject to enzymatic modification. The polymyxins penetrate to the active site and appear to be resistant to enzymatic modification. However, toxicity problems associated with polymyxin therapy prevent the widespread use of these drugs. 

Antimicrobials. Aminoglycosides (neomycin, streptomycin, gentamicin), polypeptides (colistimethate sodium, polymyxin B) and perhaps the quinolones (e.g. ciprofloxacin) may cause postoperative breathing difficulty if they are instilled into the peritoneal or pleural cavities. It appears that the antibiotics both interfere with the release of acetylcholine and also have a competitive curarelike effect on the acetylcholine receptor. 

The concomitant use of antibiotics, including the polymyxins, tetracyclines and the aminoglycosides with the non-depolarizing neuromuscular blocking agents has occasionally resulted in prolonged muscular... 

Nebulization of antibiotics in cystic fibrosis has also been reviewed (162). For P-lactams, an improvement in pulmonary function was demonstrated with carbenicillin (163). For polymyxin, colistin alone (164), or in conjunction with oral ciprofloxacin (165), there was a decrease in the rate of decline in pulmonary function and in the Ifequency of P. aeruginosa recovered from respiratory tract secretions. Antibiotics of this class have been reported to cause bronchospasm and respiratory failure (166). Aminoglycosides have been administered as aerosols since 1950, and they have demonstrated improvement of pulmonary function, decreased sputum bacterial density, no ototoxicity or renal toxicity, and according to Smith and Ramsey (162), they are of clinical benefit for patients with cystic... 

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