Category:

• Antibiotic

Description:

• Aminoglycoside antibiotic

Indications:

• Suppression of intestinal bacteria

• Hepatic coma

Contraindications:

• Presence of intestinal obstruction

• Generally not indicated for long-term therapy due to nephrotoxocity and ototoxicity

Precautions:

• Pregnancy category D

• May cause nephrotoxicity, therefore closely monitor renal function, especially in elderly patients.

• May cause ototoxicity, therefore monitor hearing

• Aminoglycosides have neuromuscular blockade activity with a curare-like effect.  Monitor patient’s neuromuscular function, especially in patients with myasthenia gravis, parkinsonism or infant botulism.

Adverse Reactions (Side Effects):

• Gastrointestinal: vomiting, nausea, anorexia

• “Malabsorption syndrome” characterized by increase in fetal fat, decrease in serum carotene and fall in xylose absorption  

Dosage:

• Administered orally

• Suppression of intestinal bacteria:

  • adjunct to mechanical cleansing

  • 1 gram every hour for 4 hours, followed by 1 gram every six hours for 36-72 hours

• Hepatic coma: 8-12 grams per day in divided doses