GENTAMYCIN (synonym: Garamycinum, Garimicinum, Gentalinum etc.; joint venture. B) — the antibiotic produced by radiant fungi of Micromonospora purpurea; treats aminoglycosides. Represents the complex consisting of components C 1 (40%), With 1 and (20%), With 2 (40%); total formula C 19-21 H 38-42 About 7 N 5 . Pier. weight 448 — 476. In clinic sulfate G., well water soluble and stable is applied at long-term storage in the form of solutions and powder, possesses a wide range of antibacterial action concerning the majority of gram-negative and gram-positive microorganisms. On G.'s range it is close to other aminoglycosides (Kanamycinum, Neomycinum), however is more active than them concerning stafilokokk, colibacilli and other activators. The most important feature distinguishing it from other antibiotics of a broad spectrum of activity is high activity concerning Pseudomonas aeruginosa. At concentration to 4 mkg/ml 80% of strains of Ps are suppressed. aeruginosa, 70% of representatives of Klebsiella, Enterobacter and to 100% of strains of stafilokokk. Affects a microbic cell bakteritsidno, suppressing synthesis of protein in the breeding cells; communicates for 25 — 30% serum proteins. Resistance to G. of in vitro increases slowly, stupeneobrazno, in the course of treatment usually is not observed. Strains, steady against G., form the specific enzymes inactivating an antibiotic. At intake of G. it is practically not soaked up; at intramuscular introduction the maximum concentration of G. in blood is observed in 1 hour and remains at the therapeutic level during 8 — 12 hours; gets through a blood-brain barrier, a placenta. It is allocated with kidneys by glomerular filtering, creating high concentration in urine.
Use in clinic
the Main indication for G.'s use are the infections caused by the activators steady against other antibiotics of a broad spectrum of activity, and first of all gram-negative microbes (pyocyanic and intestinal sticks, proteas, a klebsiyella, etc.). Drug is used at infections of urinary tract (pyelonephritises, cystitis, uretrita), respiratory tract (pneumonia, pleurisy, empyemas, abscesses), for treatment of surgical infections (sepsis, peritonitis, etc.). It is highly effective at treatment of the infected burns. It is shown at a heavy current of multi-infections before definition of an antibiotikogramma of activators.
Appoint by the adult intramusculary and intravenously in a daily dose of 0,8 — 1,8 mg/kg two-three times a day (a single dose 0,4v — 0,6 mg/kg). At the heavy course of infections it is possible to increase a dose to 5 mg/kg on condition of control of G.'s concentration in blood (not higher than 6 — 8 mkg/ml). To newborns and children up to 12 years G. apply at the rate of 0,6 mg/kg, to children 12 years — in a dose of adults are more senior. The average duration of a course of treatment of 6 — 8 days, carrying out repeated courses after 7 — a 10-day break is possible.
Locally G. apply in the form of 0,1% of solution, powders and ointments, and also by inhalations at the rate of 4 mg/ml four times a day.
It is impossible to apply along with nefro-and ototoksichny antibiotics (streptomycin, Kanamycinum, Neomycinum, Monomycinum, etc.), and also the patient who was previously receiving these drugs. It is also not recommended to apply G. to treatment of pregnant women, except for vital indications.
At G.'s appointment it is necessary to control concentration it in blood serum and to consider a functional condition of kidneys of the patient. At a renal failure of a dose of G. reduce, and intervals between introductions increase. Form of release: in bottles on 0,04 — 0,08 g
See also Antibiotics .
Bibliography: Kozhybski T., Kovshyk-Gindiferz. and Kurylovich V. Antibiotics, the lane with polsk., t. 1, page 422, Warsaw, 1969; Navashin G. M and F about m and N and I. P. Reference book on antibiotics, M., 1974; To 1 aster s k at J. Centamicin and carbenicillin, Rev. europ. etud. clin. Biol., v. 17, p. 447, 1972.
B. P. Sobolev, S. M. Navashin.