Gentamicin

Gentamicin/Prednisolone is an antibiotic and corticosteroid combination. The antibiotic works by killing sensitive bacteria. Exactly how the corticosteroid works is unknown.

Therapeutic actions:
Gentamicin is an antibiotic of aminoglycosides group of a wide spectrum of action.
Aminoglycosides work by binding to the bacterial 30S ribosomal subunit (some work by binding to the 50S subunit), inhibiting the translocation of the peptidyl-tRNA from the A-site to the P-site and also causing misreading of mRNA, leaving the bacterium unable to synthesize proteins vital to its growth. However, their exact mechanism of action is not fully known. There is no significant relationship between the dose administered and the resultant plasma level in blood. TDM, therapeutic drug monitoring, is necessary to obtain the correct dose. These agents exhibit a post-antibiotic effect in which there is no or very little drug levels detectable in blood, but there still seems to be inhibition of bacterial re-growth. This is due to strong, irreversible binding to the ribosome, and remains intracellular long after plasma levels drop. This allows a prolonged dosage interval. Depending on their concentration they act as bacteriostatic or bacteriocidial agents.

What is it used for?:
Gentamicin is widely used in the treatment of severe infections. It is active against many strains of Gram-negative bacteria and Streptococus aureus. It is inactive against anaerobes and poorly active against Streptococus haemolyticus and pneumococcus. When used as presumptive treatment prior to microbiological identification of the pathogen, gentamicin is combined with penicillin and/or metronidazole.
Examples of use: septicaemia; neonatal sepsis; neonatal meningitis; biliary tract infection; pyelonephritis, prostatitis; endocarditis.

Contraindications and cautions:
• allergy to any ingredient in Gentamicin/Prednisolone or to other corticosteroids (eg, prednisone);
• a viral infection of the eye (eg, herpes), a fungal or tuberculosis infection of the eye, certain untreated eye infections (eg, infections producing pus or discharge), or vaccinia or chickenpox infection.

Side effects:
Less serious side effects: mild burning or stinging; temporary blurred vision.

Interactions:
Other drugs, especially those that affect the kidneys, can interact with gentamicin resulting in dangerous side effects and/or decreased effectiveness. Do not take any other prescription or over-the-counter medicines, including vitamins, minerals, and herbal products, without first talking to your doctor during treatment with gentamicin.