Essay on Adverse Effects and Contraindications of Aminoglycosides

This essay provides an overview of aminoglycoside antibiotics, focusing on their adverse effects and contraindications. Aminoglycosides, while effective against Gram-negative bacteria, can cause significant side effects, including nephrotoxicity (kidney damage), ototoxicity (hearing and balance problems), and encephalopathy. The essay details how these antibiotics inhibit protein synthesis and are typically administered intravenously. It highlights the correlation between aminoglycoside use and cognitive impairment, potentially increasing the risk of neurological disorders. Specific contraindications include patients with myasthenia gravis and mitochondrial disorders, due to the drug's potential to exacerbate weakness and impair mtDNA translation, respectively. The essay also addresses the post-antibiotic effect and the risk of bacterial resistance with overuse. The concluding summary emphasizes the importance of careful dosage monitoring, especially in older patients, children, and infants, due to their increased susceptibility to adverse effects. Discontinuing medication can often reverse renal toxicity, but ototoxicity symptoms are typically irreversible. The essay includes references to support its claims.

Running head: USE OF ANTIBIOTICS
Adverse effects on use of aminoglycosides antibiotics
Name of the Student
Name of the University
Author Note

1USE OF ANTIBIOTICS
Aminoglycosides belong to the bacteriologic and medicinal category of antibacterial
agents (Gram-negative) used for therapeutic purpose. They exert their action by inhibiting
protein synthesis. Most common property of these antibiotics is observed against gram-negative
aerobic bacteria and few anaerobic bacilli. Gentamycin and streptomycin are the widely used
aminoglycoside antibiotic (Becker and Cooper 2012). Owing to the fact that aminoglycosides are
used for treating serious infections, they are usually administered intravenously into the body.
However, some aminoglycoside antibiotics are taken either in the form of eye or ear drops, or
orally (Qin et al. 2012).
The drug has been found to exert negative impacts on vision and hearing. It leads to
vestibular damage and hearing impairment. Several research studies have also established
correlation of these drugs with nephrotoxicity. Furthermore, damage of the vestibular system due
to action of aminoglycoside has been linked with cognitive impairment in several people (Dean
et al. 2012). Such cognitive impairment results in a noticeable decline in several cognitive
abilities like thinking reasoning and memory (Hooper et al. 2012). It also increases risk of the
individual to develop neurological problems such as dementia and Alzheimer's disease.
Aminoglycosides damage sensory cells, present in the ear canal (Al-Malky et al. 2015). This
results in balance impairment, dizziness, tinnitus, and hearing loss (Matt et al. 2012). Several
research studies have established aminoglycoside has the most common cause that results in drug
induced nephrotoxicity (Wargo and Edwards 2014). It manifests in the form of renal failure,
where there is a slow increase in levels of serum creatinine and hypo-osmolar urinary output.
Nephrotoxicity occurs due to retention of a small proportion of aminoglycoside in epithelial cells
that line the S1 and S2 segments of proximal convoluted tubule (Hanna et al. 2013).

2USE OF ANTIBIOTICS
Furthermore, there are certain contradictions of aminoglycoside. These antibiotics
generally exhibit weakness among patients suffering from myasthenia gravis. Hence, the drugs
are usually avoided in those patients. Additional contradictions are associated with patients
suffering from mitochondrial disorders (Wieske et al. 2014). Administration of the antibiotic
often results in impairment of mtDNA translation, which in turn increases susceptibility to
hearing loss, nephrotoxicity and cardiac toxicity (Gutiérrez Cortés et al. 2012). Moreover, the
drug also has a post-antibiotic effect where destruction of bacterial cell continues for a
considerable period of time, after fall of the blood plasma below minimum inhibitory
concentration (Singh, Sripada and Singh 2014). Excess use of the antibiotic also makes the
bacteria resistance to its action, in addition to killing intestinal flora of the colon.
To conclude, despite their antimicrobial action, frequent occurrence of ototoxicity and
renal failure due to aminoglycoside treatment makes healthcare professionals reluctant to use
these antibiotics in daily life.
Summary
Common side effects are related to development of encephalopathy, nephrotoxicity, and
ototoxicity. Administration of gentamycin has been found to affect ganglions and cranial nerves.
Overdose of gentamycin often results in myoclonus development that manifests in the form of
spasm and muscle jerk. Other side effects include skin rashes difficulty in breathing, weakness,
chills and fever. Discontinuing the medication can often reverse renal toxicity. However,
symptoms of ototoxicity are irreversible. Older patients, children and infants are at an increased

3USE OF ANTIBIOTICS
likelihood of developing the side effects upon administration of aminoglycoside. Hence, there is
a need to closely monitor the dosage of the drug.

4USE OF ANTIBIOTICS
References
Al-Malky, G., Dawson, S.J., Sirimanna, T., Bagkeris, E. and Suri, R., 2015. High-frequency
audiometry reveals high prevalence of aminoglycoside ototoxicity in children with cystic
fibrosis. Journal of Cystic Fibrosis, 14(2), pp.248-254.
Becker, B. and Cooper, M.A., 2012. Aminoglycoside antibiotics in the 21st century. ACS
chemical biology, 8(1), pp.105-115.
Dean, O.M., Bush, A.I., Copolov, D.L., Kohlmann, K., Jeavons, S., Schapkaitz, I., Anderson‐
Hunt, M. and Berk, M., 2012. Effects of N‐acetyl cysteine on cognitive function in bipolar
disorder. Psychiatry and clinical neurosciences, 66(6), pp.514-517.
Gutiérrez Cortés, N., Pertuiset, C., Dumon, E., Börlin, M., Hebert‐Chatelain, E., Pierron, D.,
Feldmann, D., Jonard, L., Marlin, S., Letellier, T. and Rocher, C., 2012. Novel mitochondrial
DNA mutations responsible for maternally inherited nonsyndromic hearing loss. Human
mutation, 33(4), pp.681-689.
Hanna, M.H., Segar, J.L., Teesch, L.M., Kasper, D.C., Schaefer, F.S. and Brophy, P.D., 2013.
Urinary metabolomic markers of aminoglycoside nephrotoxicity in newborn rats. Pediatric
research, 73(5), p.585.
Hooper, I.R., Ito, Y., Koeda, T., Kondo, S., Mitsuhashi, S., Okuda, T., Tanaka, N., Tsuchiya, T.,
Umemura, K., Umezawa, S. and Yokota, M., 2012. Aminoglycoside antibiotics (Vol. 62).
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Matt, T., Ng, C.L., Lang, K., Sha, S.H., Akbergenov, R., Shcherbakov, D., Meyer, M., Duscha,
S., Xie, J., Dubbaka, S.R. and Perez-Fernandez, D., 2012. Dissociation of antibacterial activity

5USE OF ANTIBIOTICS
and aminoglycoside ototoxicity in the 4-monosubstituted 2-deoxystreptamine
apramycin. Proceedings of the National Academy of Sciences, 109(27), pp.10984-10989.
Qin, S., Wang, Y., Zhang, Q., Chen, X., Shen, Z., Deng, F., Wu, C. and Shen, J., 2012.
Identification of a novel genomic island conferring resistance to multiple aminoglycoside
antibiotics in Campylobacter coli. Antimicrobial agents and chemotherapy, 56(10), pp.5332-
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Singh, R., Sripada, L. and Singh, R., 2014. Side effects of antibiotics during bacterial infection:
mitochondria, the main target in host cell. Mitochondrion, 16, pp.50-54.
Wargo, K.A. and Edwards, J.D., 2014. Aminoglycoside-induced nephrotoxicity. Journal of
pharmacy practice, 27(6), pp.573-577.
Wieske, L., Witteveen, E., Verhamme, C., Dettling-Ihnenfeldt, D.S., van der Schaaf, M.,
Schultz, M.J., van Schaik, I.N. and Horn, J., 2014. Early prediction of intensive care unit–
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