Gonzalez L S, Spencer J P
Department of Family Medicine, Conemaugh Memorial Medical Center, Johnstown, Pa, USA.
Am Fam Physician. 1998 Nov 15;58(8):1811-20.
Aminoglycosides are potent bactericidal antibiotics that act by creating fissures in the outer membrane of the bacterial cell. They are particularly active against aerobic, gram-negative bacteria and act synergistically against certain gram-positive organisms. Gentamicin is the most commonly used aminoglycoside, but amikacin may be particularly effective against resistant organisms. Aminoglycosides are used in the treatment of severe infections of the abdomen and urinary tract, as well as bacteremia and endocarditis. They are also used for prophylaxis, especially against endocarditis. Resistance is rare but increasing in frequency. Avoiding prolonged use, volume depletion and concomitant administration of other potentially nephrotoxic agents decreases the risk of toxicity. Single daily dosing of aminoglycosides is possible because of their rapid concentration-dependent killing and post-antibiotic effect and has the potential for decreased toxicity. Single daily dosing of aminoglycosides appears to be safe, efficacious and cost effective. In certain clinical situations, such as patients with endocarditis or pediatric patients, traditional multiple dosing is still usually recommended.
氨基糖苷类是强效杀菌性抗生素，其作用机制是在细菌细胞外膜上形成裂缝。它们对需氧革兰氏阴性菌特别有效，对某些革兰氏阳性菌有协同作用。庆大霉素是最常用的氨基糖苷类药物，但阿米卡星对耐药菌可能特别有效。氨基糖苷类用于治疗腹部和泌尿道的严重感染，以及菌血症和心内膜炎。它们也用于预防，特别是预防心内膜炎。耐药情况罕见但频率在增加。避免长期使用、血容量减少以及同时使用其他潜在肾毒性药物可降低毒性风险。由于氨基糖苷类具有快速的浓度依赖性杀菌作用和抗生素后效应，所以每日单次给药是可行的，且有可能降低毒性。氨基糖苷类每日单次给药似乎安全、有效且具有成本效益。在某些临床情况下，如心内膜炎患者或儿科患者，通常仍推荐传统的多次给药。
