sisomicin

Aminoglycosides are bactericidal antibiotics. They enter the bacterial cell via porin channels and an oxygen-dependent active transport process, then bind to ribosomal subunits, primarily 30S and 50S-30S interface. This binding freezes the initiation of protein synthesis, prevents polysome formation, and promotes disaggregation to monosomes. It also causes misreading of the mRNA code, leading to the production of abnormal or truncated proteins. The cidal action is also based on secondary changes in bacterial cell membrane integrity, leading to increased permeability and leakage, followed by cell death.

Adult

3–5 mg/kg/day (interchangeable with gentamicin doses)

Renal adjustment

CLcr (ml/min) 70 -> 70% daily, 50 -> 50% daily, 30 -> 30% daily, 20–30 -> 80% alternate day, 10–20 -> 60% alternate day, <10 -> 40% alternate day

• pregnancy
• perforated eardrum (ear drops)