Gentamicin

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Gentamicin is a powerful antibiotic. It is used when other antibiotics are not working.The active ingredient belongs to the aminoglycoside group and helps against a wide range of bacterial infections. Gentamicin is often used in combination with other antibiotics. Here you can find out everything about the mode of action, side effects and dosage of gentamicin.

This is how gentamicin works

Gentamicin is an active ingredient that is only used when standard antibiotics no longer work. A doctor prescribes gentamicin especially for severe infections caused by bacteria (e.g. urinary tract infections). The active ingredient inhibits the formation of proteins in the bacteria and thus kills them.

The substance is stored particularly well in types of bacteria with a special wall structure. The active ingredient enters the bacterium through channels in the cell wall, so-called porins. There it binds to a subunit of RNA, a genetic sequence that contains the information for the production of proteins. This leads to reading errors and, as a result, to the formation of defective proteins. These are now built into the cell membrane of the bacterium, which makes it easier for more gentamicin to penetrate. This process irrevocably leads to the death of the pathogen.

Gentamicin uptake, breakdown and excretion

Since gentamicin cannot be absorbed through the intestine, the active ingredient is in most cases infused directly into the bloodstream. From there it gets into the tissue. The substance is not broken down by the body, but excreted unchanged via the kidneys.

When is gentamicin used?

Gentamicin helps with

Infections of the urinary tract, abdomen, eyes, skin and soft tissue and after surgery
bacterial inflammation of the lining of the heart (endocarditis)

This is how gentamicin is used

Gentamicin is given to the patient as a solution for injection. The active ingredient is usually diluted in a small amount of an infusion solution in order to better distribute it in the blood and to avoid a short-term excessively high concentration of the active ingredient. With normal kidney function, a dose of 3 to 6 milligrams per kilogram of body weight (mg / kg body weight) is administered once a day.

A maximum daily dose of 6 mg / kg may be required for the treatment of severe infections or when the pathogen shows only a reduced sensitivity to the active substance.

The effects of a single dose persist, which is why gentamicin only needs to be given once a day.

What are the side effects of gentamicin?

Common side effects of gentamicin treatment are eye disorders, which manifest themselves as burning and redness of the eye. Damage to the hearing (inner ear) and the kidneys are also possible. If the hearing is impaired, a loss of the sense of balance can occur at the same time. A functional disorder of the kidney can usually be reversed by immediately stopping the active substance.

Occasionally, skin rashes, muscle pain, and an increase in body temperature may result from treatment with gentamicin.

If you experience any side effects or symptoms that are not mentioned in connection with the use of the medication, you should always consult a doctor and, if necessary, discontinue the medication on his advice.

When should gentamicin not be taken?

You should not take gentamicin if you are allergic to the active ingredient or other aminoglycosides. Likewise, a patient suffering from kidney dysfunction may only take gentamicin under close medical supervision.

Since gentamicin can disrupt the transmission of stimuli from motor nerves to the muscle, the use of the active ingredient in patients with previous neuromuscular diseases is only recommended under medical supervision. The property can be strengthened by means of muscle relaxing drugs (muscle relaxants) to such an extent that breathing difficulties up to respiratory paralysis are possible.

During pregnancy and breastfeeding, mothers should only use gentamicin after consulting their gynecologist, as the active ingredient can pass through the placenta and pass into breast milk. The active ingredient can then cause inner ear and kidney damage in the fetus and in the breastfed child fungal infections of the mouth, esophagus and intestinal mucosa. Lower doses may be required in elderly patients and patients with impaired renal function.

Simultaneous use of drugs that can also cause damage to the inner ear and kidneys as a side effect (e.g. other aminogycosides, amphotericin B, ciclosporin, cisplatin) increase the side effects in the inner ear.