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Los aminoglucósidos permanecen como una clase de antimicrobianos de uso habitual y eficaz en la práctica clínica. A pesar de que existen diversos mecanismos de resistencia continúan siendo activos frente a gran parte de los bacilos gramnegativos aerobios. En la actualidad, aunque pueden utilizarse en monoterapia en las infecciones urinarias, se utilizan fundamentalmente en combinación con betalactámicos en infecciones graves por bacilos gramnegativos. Los conocimientos sobre los parámetros farmacocinéticos y farmacodinámicos han sugerido su uso en monodosis, cuya eficacia ha sido similar a la administración en multidosis en diversos estudios, los cuales también han demostrado una tendencia a menor toxicidad. Entre los efectos adversos, la nefrotoxicidad y la ototoxicidad requieren una vigilancia cuidadosa durante su administración.
Palabras clave:
Aminoglucósidos
Monodosis
Tratamiento antimicrobiano
Aminoglycosides remain as a efficacious class of antimicrobials, commonly used in the clinical practice. In spite of the existence of several mechanisms of resistance, they continue being active against most of the aerobic Gram-negative bacilli. Currently, although aminoglycosides may be used as monotherapy in the urinary tract infections, they are mainly used in combination with β-lactam antibiotics in severe infections caused by Gram-negative bacilli. The knowledge about the pharmacokinetic and pharmacodynamic parameters of aminoglycosides has suggested their use in an once-daily dosing regimen. This dosing has shown as efficacious as multiple-daily dosing regimen in several studies, which also have shown a trend toward a lower toxicity. Among the adverse events, nephrotoxicity and ototoxicity require a careful evaluation during its administration.
Key words:
Aminoglycosides
Once-daily dosing
Antimicrobial treatment
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Bibliografía
[1.]
S.J. Pancoast.
Aminoglycoside antibiotics in clinical use.
Med Clin North Am, 72 (1988), pp. 581-612
[2.]
M.P. Mingeot-Leclercq, Y. Glupczynski, P.M. Tulkens.
Aminoglycosides: Activity and resistance.
Antimicrob Agents Chemother, 43 (1999), pp. 727-737
[3.]
M.K. Lacy, D.P. Nicolau, C.H. Nightingale, R. Quintiliani.
The pharmacodynamics of aminoglycosides.
Clin Infect Dis, 27 (1998), pp. 23-27
[4.]
W.A. Craig.
Pharmacokinetic/pharmacodynamic parameters: rationale for antibacterial dosing of mice and men.
Clin Infect Dis, 26 (1998), pp. 1-12
[5.]
D.N. Gilbert.
Aminoglycosides.
5th ed, pp. 307-336
[6.]
R.S. Edson, C.L. Terrell.
The aminoglycosides.
Mayo Clinic Proc, 74 (1999), pp. 519-528
[7.]
C.D. Freeman, D.P. Nicolau, P.P. Belliveau, C.H. Nightingale.
Once-daily dosing of aminoglycosides: Review and recomendations for clinical practice.
J Antimicrob Chemother, 39 (1997), pp. 677-686
[8.]
A.W. Urban, W.A. Craig.
Daily dosage of aminoglycosides.
Curr Clin Top Infect Dis, 17 (1999), pp. 236-255
[9.]
D.N. Fisman, K.M. Kaye.
Once-daily dosing of aminoglycoside antibiotics.
Infect Dis Clin North Am, 14 (2000), pp. 475-487
[10.]
J. Blaser, B.B. Stone, M.C. Groner, S.H. Zinner.
Comparative study with enoxacin and netilmicin in a pharmacodynamic model to determine importance of ratio of antibiotic peak concentration to MIC for bactericidal activity and emergence of resistance.
Antimicrob Agents Chemother, 31 (1987), pp. 1054-1060
[11.]
G.M. Eliopoulos, R.C. Moellering.
Antimicrobial combinations.
4th ed, pp. 330-383
[12.]
National Committee for Clinical Laboratory Standards. 2001. Performance standards for antimicrobial susceptibility testing. Document M100-S11.Wayne: National Committee for Clinical Laboratory Standards, 2001
[13.]
Recomendaciones del grupo mensura.
para la selección de antimicrobianos en el estudio de la sensibilidad y criterios para la interpretación del antibiograma.
Rev Esp Quimioterap, 13 (2000), pp. 73-86
[14.]
F.J. Schmitz, J. Verhoef, A.C. Fluit, the SENTRY Participants Group.
Prevalence of aminoglycoside resistance in 20 european university hospitals participating in the european sentry antimicrobial surveillance programme.
Eur J Clin Microbiol Infect Dis, 18 (1999), pp. 414-421
[15.]
C. Betriu, L. Palau, M. Gómez, A. Sánchez, J. Romero, J.J. Picazo.
Bacteriemias en un hospital universitario: estudio de los agentes etiológicos y de sus patrones de sensibilidad.
Rev Clin Esp, 199 (1999), pp. 503-510
[16.]
F. Fernández-Cuenca, A. Pascual, J. Vila, G. Bou, J.M. Cisneros, J. Rodríguez Baño.
Proyecto Geih-Ab 2001: Sensibilidad de Acinetobacter spp. aislados en hospitales españoles a los antimicrobianos.
X Congreso de laSociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Sevilla, 17-20 de marzo de 2002. Enferm Infecc Microbiol Clin, 20 (Suppl 1) (2002), pp. 122
[17.]
G.H. Miller, F.J. Sabatelli, R.S. Hare, H.Y. Glupczynski, P. Mackey, D. Shales.
The most frequent aminoglycoside resistance mechanisms-changes with time and geographic area: A reflection of aminoglycoside usage patterns?Clin Infect Dis, 24 (Suppl 1) (1997), pp. S46-S62
[18.]
J.C. Graham, F.K. Gould.
Role of aminoglycosides in the treatment of bacterial endocarditis.
Antimicrob Chemother, 49 (2002), pp. 437-444
[19.]
M. Hilf, L. Yu, J. Sharp, J.J. Zuravleff, J.A. Korvick, R.R. Muder.
Antibiotic therapy for Pseudomonas aeruginosa bacteremia: outcome correlations in a prospective study of 200 patients.
Am J Med, 87 (1989), pp. 540-546
[20.]
J.W. Chow, M.J. Fine, D.M. Shlaes, J.P. Quinn, D.C. Hooper, M.P. Johnson.
Enterobacter bacteremia: clinical features and emergence of antibiotic resistance during therapy.
Ann Intern Med, 115 (1991), pp. 585-590
[21.]
J.A. Korvick, C.S. Bryan, B. Farber, T.R.Jr. Beam, L. Schenfeld, R.R. Muder.
Prospective observational study of Klebsiella bacteremia in 230 patients:Outcome for antibiotic combinations versus monotherapy.
Antimicrob Agents Chemother, 36 (1992), pp. 2639-2644
[22.]
L. Liebovici, M. Paul, O. Poznanski, M. Drucker, Z. Samra, H. Konigsberger.
Monotherapy versus β-lactam-aminoglycoside combination treatment forgram-negative bacteremia: a prospective, observational study.
Antimicrob Agents Chemother, 41 (1997), pp. 1127-1133
[23.]
E. Bouza, P. Muñoz.
Monotherapy versus combination therapy for bacterial infections.
Med Clin North Am, 84 (2000), pp. 1357-1389
[24.]
J.P. Lynch, III.
Hospital-acquired pneumonia. Risk factors, microbiology, and treatment.
Chest, 119 (2001), pp. 373S-384S
[25.]
A.D.M. Kashuba, A.N. Nafziger, G.L. Drusano, J.S.Jr. Bertino.
Optimizing aminoglycoside therapy for nosocomial pneumonia caused by gram-negative bacteria.
Antimicrob Agents Chemother, 43 (1999), pp. 623-629
[26.]
E. Rozdzinski, W.V. Kern, A. Reichle, T. Moritz, T. Schmeiser, W. Gaus.
Once-daily versus thrice-daily dosing of netilmicin in combination with beta-lactam antibiotics as empirical therapy for febrile neutropenic patients.
J Antimicrob Chemother, 31 (1993), pp. 585-598
[27.]
The international antimicrobial therapy cooperative group of the european organization for research and treatment of cancer.
Efficacy and toxicity of single daily doses of amikacin and ceftriaxone versus multiple daily doses of amikacin and ceftazidime for infection in patients with cancer and granulocytopenia. Ann Intern Med, 119 (1993), pp. 584-593
[28.]
H. Ariffin, A. Arasu, M. Mahfuzah, W.A. Ariffin, L.L. Chan, H.P. Lin.
Single-daily ceftriaxone plus amikacin versus thrice-daily ceftazidime plus amikacin as empirical treatment of febrile neutropenia in children with cancer.
J Paediatr Child Health, 37 (2001), pp. 38-43
[29.]
A. Favero Del, F. Menichetti, P. Martino, G. Bucaneve, A. Micozzi, G. Gentile.
A multicenter, double-blind, placebo-controlled trial comparing piperacillin-tazobactam with and without amikacin as empiric therapy for febrile neutropenia.
Clin Infect Dis, 33 (2001), pp. 1295-1301
[30.]
P. Van der Auwera, F. Meunier, S. Ibrahim, L. Kaufman, M.P. Derde, P.M. Tulkens.
Pharmacodynamic parameters and toxicity of netilmicin (6 milligrams/kilogram/day) given once daily or in three divided doses to cancer patients with urinary tract infection.
Antimicrob Agents Chemother, 35 (1991), pp. 640-647
[31.]
R.R. Bailey, E.J. Begg, A.H. Smith, R.A. Robson, K.L. Lynn, S.T. Chambers.
Prospective, randomized, controlled study comparing two dosing regimens of gentamicin/oral ciprofloxacin switch therapy for acute pyelonephritis.
Clin Nephrol, 46 (1996), pp. 183-186
[32.]
J.R. Carapetis, A.L. Jaquiery, J.P. Buttery, M. Starr, N.E. Cranswick, S. Kohn.
Randomized, controlled trial comparing once daily and three times daily gentamicin in children with urinary tract infections.
Pediatr Infect Dis J, 20 (2001), pp. 240-246
[33.]
J.W. Warren, E. Abrutyn, J.R. Hebel, J.R. Johnson, A.J. Schaeffer, W.E. Stamm.
Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis in women.
Clin Infect Dis, 29 (1999), pp. 745-758
[34.]
T. Sandberg, K. Alestig, T. Eilard, E. Ek, M. Hebelka, E. Johansson.
Aminoglycosides do not improve the efficacy of cephalosporins for treatment of acute pyelonephritis in women.
Scand J Infect Dis, 29 (1997), pp. 175-179
[35.]
K. Tan, H. Bunn.
Once daily multiple daily dosing with intravenous aminoglycosides for cystic fibrosis.
Cochrane Database Syst Rev, 4 (2000), pp. CD002009
[36.]
A. Whitehead, S.P. Conway, C. Etherington, N.A. Caldwell, N. Setchfield, S. Bogle.
Once-daily tobramycin in the treatment of adult patients with cystic fibrosis.
Eur Respir J, 19 (2002), pp. 303-309
[37.]
R.B. Moss.
Long-term benefits of inhaled tobramycin in adolescent patients with cystic fibrosis.
Chest, 121 (2002), pp. 55-63
[38.]
X. Badía, M. Brosa, J.M. Tellado.
Medicina basada en la evidencia, costes sanitarios y tratamiento de la infeccion intraabdominal.
Enferm Infecc Microbiol Clin, 17(Supl 2 (1999), pp. 86-94
[39.]
H. Dupont, C. Carbon, J. Carlet, for The Severe Generalized Peritonitis Group.
Monotherapy with broad-spectrum beta-lactam is as effective as its combination with an aminoglucoside in treatment of severe generalized peritonitis: a multicenter randomized controlled trial.
Antimicrob Agents Chemother, 44 (2000), pp. 2028-2033
[40.]
R.G. Holzheimer, H. Dralle.
Antibiotic therapy in intra-abdominal infections –a review on randomised clinical trials.
Eur J Med Res, 6 (2001), pp. 277-291
[41.]
P.A. Gross, T.L. Barrett, E.P. Dellinger, P.J. Krause, W.J. Martone, J.E. McGowan.
Purpose of quality standars for infectious diseases.
Clin Infect Dis, 18 (1994), pp. 421
[42.]
O. Lortholary, M. Tod, Y. Cohen, O. Petitjean.
Aminoglycosides.
Med Clin North Am, 79 (1995), pp. 761-787
[43.]
D.N. Gilbert, W.M. Bennett.
Use of antimicrobial agents in renal failure.
Infect Dis Clin North Am, 3 (1989), pp. 517-531
[44.]
Nicolau DP, Freeman CD, Belliveau PP, Nightingale CH, Ross JW, Quintiliani R. Experience with a once-daily aminoglycoside program administered to 2184 adult patients. Antimicrob Agents Chemother
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