O uso da gentamicina e sua monitorização terapêutica

Abstract

Gentamicin is an antibiotic belonging to the class of natural aminoglycosides, being obtained from the fermentation of actinomycetes of the genus Micromonospora. It was discovered in 1963 in the United States by a group of researchers from the Department of Microbiology at Schering Corporation. It is an antibiotic widely used due to its low cost and effectiveness in the treatment of serious infections caused by gram-negative bacteria and some aerobic gram-positive bacteria. This drug has bactericidal action acting on the inhibition of protein synthesis. It is used for the treatment of sepsis, purulent meningitis, pyelonephritis and in some cases caused by gram-positive bacilli. The use of gentamicin is often limited in clinical practice because it has a narrow therapeutic index which gives high potential to induce toxicity. The principal adverse reactions of gentamicin are: nausea, vomiting, headache, transient proteinuria, increase in transaminases and alkaline phosphatase, neuromuscular blockade, and with greater frequency and severity, nephrotoxicity and ototoxicity. The treatment regimen in a single dose is associated with lower toxicity, lower cost, ease of administration and provides the same effectiveness compared to the regimen of multiple doses. The therapeutic monitoring of this drug is an essential measure to ensure optimal therapeutic concentrations and minimize the risks of adverse drug effects with the individualization of dose.