Schaad U B
Pädiatrische Universitätsklinik, Kinderspital Basel.
Schweiz Med Wochenschr Suppl. 1996;76:34S-38S.
The aminoglycosides continue to be needed in hospital pediatrics. Their advantage is high predictability of both efficacy and toxicity. This review focuses on the background to the aminoglycosides and defines their present role in antibiotic therapy of pediatric patients. Both the beneficial and unfavourable characteristics of these antimicrobial agents are discussed. The clinical uses of aminoglycoside antibiotics and their possible modes of administration are also commented on. The author attempts to compare the currently available aminoglycosides gentamicin, tobramycin, amikacin and netilmicin in the light of their antibacterial activity in vitro, their clinical efficacy, and their ototoxic and nephrotoxic potential. For the future it is important not to lose sight of these backup drugs where appropriately and safely used. A possible renaissance of the aminoglycosides would require either a molecular miracle (new aminoglycosides with decreased toxicity and an increased spectrum of activity) or a bacterial revolt (rapid emergence of resistance of many gram-negative enteric bacilli to other antibiotic classes).
氨基糖苷类药物在医院儿科中仍然不可或缺。其优势在于疗效和毒性的高度可预测性。本综述聚焦于氨基糖苷类药物的背景，并明确其在儿科患者抗生素治疗中的当前作用。文中讨论了这些抗菌药物的有利和不利特性。还对氨基糖苷类抗生素的临床应用及其可能的给药方式进行了评论。作者试图根据庆大霉素、妥布霉素、阿米卡星和奈替米星目前的体外抗菌活性、临床疗效以及耳毒性和肾毒性潜力，对它们进行比较。对于未来而言，重要的是在适当且安全使用的情况下，不要忽视这些备用药物。氨基糖苷类药物若要迎来可能的复兴，要么需要一个分子奇迹（毒性降低且活性谱增加的新型氨基糖苷类药物），要么需要一场细菌反抗（许多革兰氏阴性肠道杆菌对其他抗生素类别迅速产生耐药性）。
