Barza M, Scheife R T
Am J Hosp Pharm. 1977 Jul;34(7):723-37.
The aminoglycoside antibiotics are reviewed with regard to mechanism of action, bacterial resistance, antimicrobial spectrum, combinations with other agents, pharmacology, dosages in patients with normal and impaired renal function, adverse reactions, therapeutic use, prophylatic use and selection. Streptomycin is suggested in the therapy of tuberculosis, brucellosis, tularemia and yersinia infections; several of these require the coadministration of another agent. The choice between streptomycin and gentamicin for combination therapy of enterococcal endocarditis may be simplified by knowledge of the prevalence of high-level streptomycin-resistant strains in the hospital or by use of an in vitro screening test. Neomycin is the agent used orally in the treatment of hepatic encephalopathy. Paromomycin is indicated only for the treatment of amebic infections. The major difference among gentamicin, tobramycin and amikacin lies in the low but increasing prevalence of gram-negative bacilli which are resistant to gentamicin and tobramycin and susceptible to amikacin. In those institutions in which gentamicin-resistant strains are of concern, amikacin is the aminoglycoside of choice in high-risk patients until the infecting bacterium has been determined.
对氨基糖苷类抗生素在作用机制、细菌耐药性、抗菌谱、与其他药物的联合应用、药理学、肾功能正常和受损患者的剂量、不良反应、治疗用途、预防用途及选择等方面进行了综述。链霉素适用于治疗结核病、布鲁氏菌病、兔热病和耶尔森菌感染；其中几种感染需要联合使用另一种药物。对于肠球菌性心内膜炎的联合治疗，通过了解医院中高水平链霉素耐药菌株的流行情况或使用体外筛选试验，可简化链霉素和庆大霉素之间的选择。新霉素是口服用于治疗肝性脑病的药物。巴龙霉素仅用于治疗阿米巴感染。庆大霉素、妥布霉素和阿米卡星之间的主要区别在于，对庆大霉素和妥布霉素耐药但对阿米卡星敏感的革兰氏阴性杆菌的流行率较低但呈上升趋势。在那些关注庆大霉素耐药菌株的机构中，在确定感染细菌之前，阿米卡星是高危患者的首选氨基糖苷类药物。
