From the FDA Drug Label
Tobramycin for Injection, USP is supplied as a dry powder in a bulk package vial. Amikacin sulfate injection, USP is a semi-synthetic aminoglycoside antibiotic derived from kanamycin. Tobramycin sulfate, a water-soluble aminoglycoside antibacterial, drug derived from the actinomycete Streptomyces tenebrarius.
The brand name and generic of aminoglycosides in the US are:
- Tobramycin (generic)
- Amikacin (generic) Note that the provided drug labels do not contain information on brand names, only generic names are mentioned 1, 2, 1.
From the Research
Aminoglycosides available in the US include both generic and brand name options, with the main aminoglycosides being gentamicin, tobramycin, amikacin, streptomycin, neomycin, and plazomicin, as noted in a review of aminoglycosides 3. The most recent and highest quality study on aminoglycosides, published in 2016, provides an overview of these antibiotics, highlighting their natural or semisynthetic origin, their mechanism of action, and their use in treating serious infections 3.
Key Points
- Gentamicin is commonly used for serious infections including sepsis, pneumonia, and UTIs, and is available under the brand name Garamycin.
- Tobramycin is particularly effective against Pseudomonas aeruginosa and is available in inhaled formulations for cystic fibrosis patients, under the brand names Tobrex and TOBI.
- Amikacin is often reserved for multidrug-resistant infections due to its broader spectrum, and is available under the brand name Amikin.
- Neomycin is primarily used topically or orally for bowel preparation, under the brand name Neo-Fradin.
- Streptomycin, one of the oldest aminoglycosides, is now mainly used for tuberculosis.
- Plazomicin is a newer aminoglycoside approved for complicated urinary tract infections, and is available under the brand name Zemdri.
Important Considerations
- When using aminoglycosides, monitoring for nephrotoxicity and ototoxicity is essential, as noted in a study on the aminoglycosides published in 1987 4.
- Dosing is often based on weight and renal function, with many institutions using extended-interval dosing (once-daily) to maximize efficacy while minimizing toxicity, as discussed in a review of aminoglycosides published in 1998 5.
Mechanism of Action
- Aminoglycosides work by binding to bacterial ribosomes and inhibiting protein synthesis, making them effective against many gram-negative bacteria and some gram-positive organisms, as explained in a study on the aminoglycosides published in 1982 6.
Resistance and Usage
- Resistance to aminoglycosides is a concern, and their use should be guided by susceptibility testing and clinical experience, as noted in a study on the aminoglycosides published in 1983 7.
- Aminoglycosides are often used in combination with other antibiotics to extend their spectrum and take advantage of possible synergy, as discussed in a review of aminoglycosides published in 1982 6.