Gram-negative infections aminoglycoside antibiotics

Pharmacology The aminoglycosides are bactericidal antibiotics used primarily in the treatment of gram-negative infections. 

Aztreonam, a monobactam, is a useful alternative for patients with aerobic gram-negative infections who are allergic to penicillins, but has no activity against anaerobes. Aztreonam appears to be the only p-lactam antibiotic that can be safely administered to penicillin-allergic patients [58]. Aztreonam has a spectrum of activity that is comparable to the aminoglycosides but it is less nephrotoxic in patients [59] and it appears to be well tolerated in infants and children [60]. 

Aminoglycosides The aminoglycosides are important antimicrobial drugs used alone or in combination with )S-lactam antibiotics for the treatment of certain serious gram-negative infections. Chemically, the aminoglycosides consist of various sugars... 

Tobramycin is an aminoglycoside antibiotic used to treat aerobic gram negative infections, such as Eschericia Coli, Enterobacter species, Pseudomonas species, or Staphylococcus Aureus. Aminoglycosides are notorious for their narrow therapeutic index and tobramycin is no exception. Prolonged exposure to aminoglycosides may... 

The discovery of Gentamydn and its successful utilisation for the treatment of serious gram-negative infections has contributed in the last years to increasing clinical use and to a rapid development of the chemistry and biochemistry of aminoglycoside antibiotics. Also of importance in the further exploration of this class of compounds are the new chemical and physico-chemical methods, e.g. H- and C-NMR-spectroscopy, mass spectroscopy. X-ray analysis and the different chromatographic methods. Synthetic efforts and studies of the inactivation mechanism have provided a preliminary insight into the relationship between structure and activity. 

Aztreonam may be used as a substitute for an aminoglycoside in the treatment of infections caused by susceptible gram-negative organisms. Most of the adverse effects of aztreonam are local reactions at the site of injection. Interestingly, aztreonam rarely causes allergic reactions in patients with a history of type I hypersensitivity to other (3-lactam antibiotics. 

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