uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Rational use of aminoglycosides-Review and recommendations by the Swedish Reference Group for Antibiotics (SRGA)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases. (Sjölin)
Show others and affiliations
2013 (English)In: Scandinavian journal of infectious diseases, ISSN 1651-1980, Vol. 45, no 3, 161-175 p.Article, review/survey (Refereed) Published
Abstract [en]

The Swedish Reference Group for Antibiotics (SRGA) has carried out a risk-benefit analysis of aminoglycoside treatment based on clinical efficacy, antibacterial spectrum, and synergistic effect with beta-lactam antibiotics, endotoxin release, toxicity, and side effects. In addition, SRGA has considered optimal dosage schedules and advice on serum concentration monitoring, with respect to variability in volume of drug distribution and renal clearance. SRGA recommends that aminoglycoside therapy should be considered in the following situations: (1) progressive severe sepsis and septic shock, in combination with broad-spectrum beta-lactam antibiotics, (2) sepsis without shock, in combination with broad-spectrum beta-lactam antibiotics if the infection is suspected to be caused by multi-resistant Gram-negative pathogens, (3) pyelonephritis, in combination with a beta-lactam or quinolone until culture and susceptibility results are obtained, or as monotherapy if a serious allergy to beta-lactam or quinolone antibiotics exists, (4) serious infections caused by multi-resistant Gram-negative bacteria when other alternatives are lacking, and (5) endocarditis caused by difficult-to-treat pathogens when monotherapy with beta-lactam antibiotics is not sufficient. Amikacin is generally more active against extended-spectrum beta-lactamase (ESBL)-producing and quinolone-resistant Escherichia coli than other aminoglycosides, making it a better option in cases of suspected infection caused by multidrug-resistant Enterobacteriaceae. Based on their resistance data, local drug committees should decide on the choice of first-line aminoglycoside. Unfortunately, aminoglycoside use is rarely followed up with audiometry, and in Sweden we currently have no systematic surveillance of adverse events after aminoglycoside treatment. We recommend routine assessment of adverse effects, including hearing loss and impairment of renal function, if possible at the start and after treatment with aminoglycosides, and that these data should be included in hospital patient safety surveillance and national quality registries.

Place, publisher, year, edition, pages
2013. Vol. 45, no 3, 161-175 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-189469DOI: 10.3109/00365548.2012.747694ISI: 000314941600001PubMedID: 23270477OAI: oai:DiVA.org:uu-189469DiVA: diva2:581498
Available from: 2013-01-02 Created: 2013-01-02 Last updated: 2013-03-19Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Furebring, MiaMelhus, AsaSjölin, Jan
By organisation
Infectious DiseasesClinical Bacteriology
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 131 hits
ReferencesLink to record
Permanent link

Direct link