氨基糖甙类
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氨基糖甙类
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- PubMed ID
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31643557 (在PubMed]
- 文摘
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氨基糖甙类天然产物,半合成衍生品从各种各样的放线菌和强有力的活动对许多革兰氏阴性细菌。第一个氨基糖苷类用于临床实践是链霉素源自链霉菌属将是第一个有效的代理对结核分枝杆菌。链霉素的抗菌活性的发现和特征导致的奖诺贝尔医学奖塞尔曼Waksman和他的同事。两个或两个以上的氨基糖甙类有共同的结构氨基糖加入己糖核糖苷键。氨基糖甙类被认为采取行动通过绑定的细菌核糖体蛋白质合成和阻塞。氨基糖甙类在当前使用在美国包括链霉素、庆大霉素、妥布霉素、丁胺卡那霉素、plazomicin和新霉素。氨基糖甙类口服吸收差,通常给出非肠道,通过静脉注射或肌内注射。庆大霉素、妥布霉素和阿米卡星给出非肠道和用于严重的革兰氏阴性细菌感染通常结合青霉素或头孢菌素。链霉素现在很少使用,主要是辅助治疗耐多药结核病。Plazomicin是最近推出了代理和静脉注射作为单一疗法复杂尿路感染或急性肾盂肾炎。 Plazomicin is a semi-synthetic aminoglycoside which has been modified to evade conventional forms of aminoglycoside resistance. Neomycin is used orally to treat hepatic encephalopathy. Because it is poorly absorbed orally, neomycin causes a decrease in intestinal bacteria, thereby decreasing ammonia production and absorption from the colon. The aminoglycosides all have serious toxicities which often limit their applicability and the dose and duration of therapy. The common serious adverse effects of the aminoglycosides are ototoxicity, neuropathy and nephrotoxicity. Liver injury from the aminoglycosides is rare, perhaps because the other side effects of aminoglycosides limit the amount that can be given. Isolated case reports of idiosyncratic hepatotoxicity have been published for most, but not all of the aminoglycosides. These resports have not always been very convincing.
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