Terapia vestibular en vestibulopatía bilateral por gentamicina: reporte de un caso y revisión de la literatura / Vestibular therapy in a case of gentamicin-induced vestibulopathy: case report and literature revision

La vestibulopatía bilateral es poco frecuente, se caracteriza principalmente por inestabilidad al caminar o al estar de pie, visión borrosa inducida por el movimiento u oscilopsia al caminar o al realizar movimientos rápidos de la cabeza o del cuerpo, empeoramiento de la estabilidad en la oscuridad o terrenos irregulares, reducción de los síntomas al estar en condiciones estáticas, ganancia del reflejo vestíbulo-ocular angular reducida de forma bilateral, entre otros. Existen múltiples causas. Dentro de las causas identificables, se describen principalmente medicamentos ototóxicos, meningitis y enfermedad de Ménière. Se presenta el caso de una paciente de 64 años diagnosticada con vestibulopatía bilateral posterior a tratamiento intramuscular con gentamicina por sobreinfección bacteriana cutánea de las manos. La evaluación vestibular complementada con videonistagmografía y prueba de impulso cefálico asistida por video confirman el diagnóstico y se inicia tratamiento con rehabilitación vestibular enfocada en promover la compensación central a través de estrategias de sustitución principalmente; además de habituación y adaptación vestibular, favoreciendo la estabilización de la mirada, mantención del equilibrio, control postural, marcha y reducción de los síntomas.

Bilateral vestibulopathy is infrequent, and it is characterized mostly by unstable walking or when standing, blurred vision induced by movement, or oscillopsia when walking or performing fast movements; worsening of the stability in darkness or uneven ground, but with lack of symptoms in static conditions. Other symptoms may include bilateral reduction of the oculo-vestibular reflex. Among the identifiable causes, there is the use of ototoxic medication, meningitis, Ménière's disease, although it can be idiopathic or have a neurological cause. We hereby describe the case of a 64-year-old woman, diagnosed with bilateral vestibulopathy secondary to intramuscular treatment with gentamicin due to a bacterial hand infection. Vestibular assessment was complemented with video-nystagmography and video head impulse test which confirmed the diagnosis, and therapy was started with vestibular rehabilitation focused on promoting central compensation mainly, through substitution strategies. Also, habituation exercise and vestibular adaptation strategies were used, thus promoting sight stabilization, balance maintenance, postural control, walking, and reduction of the symptoms.

Antibiotic-Resistant Salmonella, isolated from cloacal swab samples from turtles in Guatemala / Salmonella resistente a antibióticos, aislada de muestras de hisopados cloacales en tortugas de Guatemala

Salmonellosis is a relevant public health threat worldwide. Reptiles are commonly involved in human cases. A microbiological survey was conducted from August to October 2018 to isolate Salmonella bacteria and de-termine if they were resistant to regularly used antibiotics in eight species of pet turtles (Kinosternon acutum sp., K. leucostomum, K. scorpioides, Rhinoclemmys areolata sp., R. pulcherrima, Staurotypus salvinii sp., Trachemys scripta and T. venusta) in Guatemala city, San Lucas Sacatepéquez and Antigua Guatemala. Cloacal swabs were taken from 63 turtles and cultivated in the Microbiology Laboratory at the Veterinary Medicine and Animal Hus-bandry Faculty, University of San Carlos of Guatemala, in Guatemala City. Three samples were positive to the presence of Salmonella sp. One of these isolates (from Trachemys scripta) was resistant to gentamicin, penicillin and amikacin, other isolate (from T. scripta) was partially resistant to amoxicilin + clavulanic acid and penicillin, and other (from T. venusta) to penicillin. These findings highlight the need for better biosecurity practices and show the capacity of bacteria to develop survival strategies that involve resistance to harmful substances like antibiotics.

La salmonelosis es una importante enfermedad zoonótica considerada una amenaza a la salud pública a nivel mundial. Los reptiles están comúnmente involucrados en la transmisión animal-humano. Con el objetivo de determinar la presencia de Salmonella y determinar su resistencia a antibióticos de uso común, se realizó un estudio exploratorio en ocho especies de tortugas (Kinosternon acutum sp., K. leucostomum, K. scorpioides, Rhinoclem-mys areolata sp., R. pulcherrima, Staurotypus salvinii sp., Trachemys scripta y T. venusta) en Guatemala y en San Lucas Sacatepéquez. Se tomaron hisopados cloacales de 63 especímenes y se cultivaron en el Laboratorio de Microbiología de la Facultad de Medicina Veterinaria y Zootecnia de la Universidad de San Carlos de Guatemala. Tres muestras fueron positivas a la presencia de Salmonella sp. Uno de los aislados (de Trachemys scripta) fue resistente a gentamicina, penicilina y amikacina, otro aislado (de T. scripta) fue parcialmente resistente a amoxicilina + ácido clavulánico y a penicilina y un tercer aislado (de T. venusta) a penicilina. Estos hallazgos resaltan la necesidad de mejores prácticas de bioseguridad y muestran la capacidad de las bacterias para desarrollar estrategias de sobrevivencia que involucran la resistencia a sustancias que les son nocivas, como los antibióticos.

Renoprotective Effects of Gallic Acid Against Gentamicin Nephrotoxicity Through Amelioration of Oxidative Stress in Rats

Abstract Gallic acid (GA), as a strong antioxidant, was selected in this study to investigate its possible nephroprotective effects against gentamicin (GM)-induced nephrotoxicity. Twenty-four rats were separated into three groups (n=8): group 1 (control group) received saline (0.5 mL/day), group 2 (GM group) received GM (100 mg/kg/day), and group 3 (treated group) received GM (100 mg/kg/day) and GA (100mg/kg/day). All treatments were performed intraperitoneally for 12 days. After 12 days, the rats were euthanized, and kidneys were removed immediately. For serum preparation, blood samples were collected before killing. Kidney paraffin sections were prepared from one of the kidneys and stained by the periodic acid-Schiff process. GA significantly decreased GM-induced renal histopathological injuries, including tubular necrosis, tubular cast, and leucocyte infiltration compared with the GM group. Additionally, GA significantly improved proteinuria, serum levels of urea and creatinine, and serum activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) compared with nephrotoxic animals. Furthermore, GA caused a significant improvement in the levels of cholesterol (Chol), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and cardiac risk ratios 1 and 2 in comparison with nephrotoxic animals. GA administration was observed to significantly improve the levels of lipid peroxidation, nitric oxide (NO), and glutathione (GSH) compared with the GM group. Finally, the activities and gene expression levels of catalase (CAT) and glutathione peroxidase (GPX) significantly increased following GA administration compared with the GM group. Our results indicated that GA has potential protective effects against GM nephrotoxicity by reducing oxidative stress in rats.

Clinical pharmacology of gentamicin in neonates: regimen, toxicology and pharmacokinetics / Farmacologia clínica da gentamicina em neonatos: modalidades de uso, toxicologia e farmacocinética

Gentamicin is an aminoglycoside antibiotic. It kills bacteria by inhibiting protein synthesis and to some extent by lysing the cell envelope. Gentamicin is frequently the first choice drug because of its reliability, but also because of the long experience with its use. In combination with β-lactam antibiotics it is recommended for the treatment of sepsis or pneumonia and is active against P. aeruginosa, Enterobacter, Klebsiella and Serratia. However, gentamicin is ototoxic and nephrotoxic. The human mitochondrial genetic variant m.1555A > G has been reported to be an important cause of non-syndromic hereditary hearing dysfunction and may cause permanent hearing loss. Even short courses of gentamicin therapy in healty newborn infants can lead to abnormalities of auditory function. It is active against very resistant bacteria at peak concentrations (> 10 mg/l) that are high enough to be potentially toxic. For safe therapeutic efficacy, peak plasma concentrations of gentamicin should range from 4 to 10 mg/l; but trough concentrations, immediately before a new drug administration, must be lower that 2 mg/L to avoid toxic effects. Pharmacokinetic parameters vary considerably in infants. Half-life ranges from 5.4 to 10.0 hours, clearance 0.50 to 1.71 ml/h/kg and distribution volume from 0.4 to 0.7 l/kg. Preterm infants have a longer half-life than full-term infants. Thus, it is mandatory to monitor gentamicin serum concentrations whenever infants are treated for 48 hours or more.

A gentamicina é antibiótico do grupo dos aminoglicosídeos. Destrói bactérias por inibição de síntese proteica e, em certa medida, por lise do envelope celular. A gentamicina é a droga de primeira escolha por causa de sua atividade confiável e em virtude de longa experiência com seu uso. Em combinação com antibióticos β-lactâmicos é recomendada para o tratamento de septicemia ou pneumonia e é ativa contra P. aeruginosa, Enterobacter, Klebsiella e Serratia. No entanto, a gentamicina é ototóxica e nefrotóxica. A variante genética mitocondrial humana m.1555A > G é tida como importante causa de disfunção auditiva hereditária não-sindrômica e pode causar perda permanente da audição. Até mesmo procedimentos terapêuticos de gentamicina de curta duração em recém-nascidos sadios podem levar a anormalidades da função auditiva. É ativa contra algumas espécies de bactérias apenas em concentrações de pico (> 10 mg/l) que são suficientemente altas para produzirem efeitos tóxicos. A gentamicina deve cair a concentrações mínimas menores que 2 mg/l para evitar efeitos tóxicos. Para produzir efeitos terapêuticos, as concentrações plasmáticas máximas de gentamicina deve variar de 4 a 10 mg/l. Os parâmetros farmacocinéticos variam consideravelmente em lactentes. A meia-vida varia entre 5,4-10,0 horas, o "clearance" varia entre 0,50 e 1,71 ml/h/kg e volume de distribuição de 0,4-0,7 l/kg. Em prematuros a meia-vida é mais longa do que a de crianças nascidas a termo. Por esses motivos, sempre que lactentes são tratadas durante 48 horas ou mais, monitorizar as concentrações séricas de gentamicina é essencial.

Aggravation of gentamicin induced nephrotoxicity by ciprofloxacin

To evaluate histopathological changes of gentamicin induced nephrotoxicity in rabbits receiving the combination of ciprofloxacin and gentamicin compared with rabbits receiving gentamicin alone. Laboratory based Randomized controlled trial. Study was conducted in the department of Histopathology with the collaboration of the department of Pharmacology, Army Medical College Rawalpindi and National University of Sciences and Technology [NUST] Islamabad. Eighteen rabbits were used in this study. They were divided randomly into three groups. Each group contained six rabbits. Group 1 [control] was injected subcutaneously with 0.9% NaCl. The second group of animals was injected with gentamicin. The third group of animals was injected with the same dose of gentamicin and additionally ciprofloxacin. The findings were entered and analyzed with the help of histopathological [HP] score calculated by summing up the histological parameters through Microsoft excel and Graph pad Instat 3. Necrosis, congestion and inflammatory infiltrate were graded as absent, mild, moderate and severe. The score assigned was from 0 to 4 accordingly. Highest tubular necrosis grade [grade 3] and maximum inflammatory changes [moderate grade] were observed in 50% of rabbits of group 3, receiving combination of gentamicin and ciprofloxacin. p-values were significant <0.01. Combined administration of ciprofloxacin along with gentamicin in rabbits enhances adverse histopathological effects of gentamicin induced nephrotoxicity

Comparative nephrotoxic effects of gentamycin and tobramycin

To compare the nephrotoxic effects of two aminoglycosides namely, gentamycin and tobramycin on rabbits. Comparative study. Allama Iqbal Medical College Lahore, from January 2010 to December 2010. The serum levels of creatinine and electrolytes [sodium and potassium] were measured in different groups of rabbits [control group-A, gentamycin group B and tobramycin-group C]. Rabbits in group B and C received laboratory diet and 32 mg/kg/day of gentamycin and tobramycin were given through intramuscular [IM] route twice daily for 7 days. Blood samples were collected on day 1, 10, 16, and 22 of drug administration. Each rabbit of all groups was sacrificed on 22[nd] day of experiment. Kidneys were removed and histological examination of the 4 components of the renal tissue [glomeruli, tubules, blood vessels and interstitial tissue] was carried out. Level of serum creatinine was significantly increased in both experimental groups [B and C] as compared to the control group A. On the other hand, level of serum sodium was insignificantly increased in groups B and C, whereas level of serum potassium was significantly decreased in groups of rabbits receiving gentamycin and tobramycin as compared to control group. There was no significant difference in nephrotoxicity between gentamycin and tobramycin

Once versus individualized multiple daily dosing of aminoglycosides in critically ill patients

The purpose of this study was to evaluate the once daily dosing [ODD] program in critically ill Egyptian patients compared to individualized multiple daily dosing [MDD] in terms of clinical and bacteriological efficacy. In addition, the incidence of nephrotoxicity associated with both regimens in this specific group of patients was assessed. Fifty-two patients with suspected or confirmed bacterial infections admitted to the Critical Care Medicine Department, Kasr El-Aini-Cairo University Hospitals comprised the study population. The amikacin group [30 patients] was sub-divided into 14 patients receiving amikacin ODD [1 g i.v.] and 16 patients receiving amikacin in MDD [500 mg i.v./dose]. The gentamicin group [22 patients] was sub-divided into 10 patients receiving the drug ODD [240 mg i.v.] and 12 patients receiving gentamicin MDD [80 mg i.v./dose]. Amikacin or gentamicin serum levels were determined by the enzyme multiplied immunoassay technique using Emit 2000. MDD regimen was adjusted based on the individual pharmacokinetic parameters using the Sawchuk-Zaske method. There was no significant difference between the two dosing regimens with regard to clinical and antibacterial efficacy or incidence of nephrotoxicity of both gentamicin and amikacin groups. In the ODD regimen, duration of treatment had no effect on increasing incidence of nephrotoxicity unlike the individualized MDD regimen. No dose adjustments were needed in the once daily dosing regimen since trough concentrations have never been above toxic level. The study showed that the ODD regimen is preferred in critically ill patients to individualized MDD as shown by comparable efficacy, nephrotoxicity and lesser need for therapeutic drug monitoring and frequent dose adjustments required in the individualized MDD regimen

Dermatitis de contacto a gentamicina: a propósito de un caso / Contact dermatittis to gentamicin: a propos of a case

Los aminoglucósidos poseen un escaso potencial sensibilizante, aunque algunos como la neomicina pueden inducir reacciones de hipersensibilidad y erupciones cutáneas, además de reacciones cruzadas con otros aminoglucósidos. Se presenta el caso de una mujer de 19 años quien recibía tratamiento con una crema de gentamicina, por tener una ulceración en zona centroesternal, y desarrolla lesiones eczematosas a las seis semanas de tratamiento. Se realizaron pruebas epicutáneas con batería estándar y de antibióticos, siendo positiva sólo a gentamicina. La dermatitis de contacto alérgica aislada a gentamicina es un hecho poco frecuente, pero se debe tener en cuenta cuando se observa un enlentecimiento en el proceso de cicatrización de las heridas o la aparición de cuadros eczematosos tras su aplicación. Los factores favorecedores más importantes parecen ser su aplicación sobre superficies ulceradas y el tratamiento prolongado.

Aminoglycosides have a low sensitizing potential, although some such as neomycin can induce hypersensitivity reactions and rashes; in addition to cross-reactions to other aminoglycosides. We present the case of a 19-year-old woman, who was being treated with topic gentamicin because of an ulcer in centroesternal area, and developed eczematous lesions at six weeks of treatment. Patch test was done with the standard and antibiotic battery, being only positive to gentamicin. Allergic contact dermatitis to gentamicin alone is of rare occurrence, but it should be considered when there is a slowing in the process of healing or when eczematous lesions developed after its application. The most important enhancing factors seem to be its application on ulcerated surfaces and prolonged treatment.

Estudo experimental anatômico-funcional da cocleotoxicidade da gentamicina com doses habituais para recém-nascidos / Experimental morphological and functional study of gentamicin cochleotoxicity using the regular dose given to neonates

BACKGROUND: gentamicin is an antibiotic that acts in Gram-negative bacilli infections, having as a side effect ototoxicity. Ototoxicity is an iatrogenic disturb provoked by drugs that modify the internal ear, affecting the cochlear and/or vestibular system and causing alterations in two important functions: equilibrium and audition. The main pediatric groups that receive aminoglicosides antibiotics are newborns who present serious infections in Neonate intensive care units. AIM: to verify the occurrence of external cilliary cells (ECC) caused by gentamicin with single dose schemas of 4mg/kg/day and 2,5mg/kg/day every 12 hours, through a morphological - scanning electronic microscopy (SEM) and functional - distortion product otoacoustic emissions (DPOAE) experimental study. METHOD: 26 albino guinea pigs were evaluated through DPOAE pre and post gentamicin treatment. The guinea pigs were sacrificed in the programmed time after the intramuscular administration of the drugs for anatomic analysis using MEV. RESULTS: the evaluation of the functional state of the ECC indicated preservation of the DPOAE in all of the guinea pigs. The SEM results, after being photographed were analyzed in terms of the number of the ECC in the cochlear basal turn in a specific photographic field. CONCLUSION: lesions or alterations in the functioning of the ECC of albino guinea-pigs after the use of 4mg/Kg/day and 2,5mg/Kg/day every 12 hours for a period 10 and 14 days were not observed.

TEMA: a gentamicina é um antibiótico que atua nas infecções causadas por bacilos Gram-negativos. Seu efeito colateral mais importante é a ototoxicidade. As ototoxicoses são afecções iatrogênicas provocadas por fármacos que alteram a orelha interna, podendo afetar o sistema coclear e/ou vestibular, alterando duas funções importantes: a audição e o equilíbrio. Os principais grupos pediátricos que recebem antibióticos aminoglicosídeos são recém-nascidos com infecções graves na UTI neonatal. OBJETIVOS: verificar a ocorrência de lesão às células ciliadas externas (CCE) pela gentamicina com os esquemas de dose única de 4mg/Kg/dia e de 2,5mg/Kg/dia a cada 12 horas, por meio de um estudo anatômico por microscopia eletrônica de varredura (MEV) e estudo funcional através das emissões otoacústicas por produto de distorção (OEAPD). Forma de estudo experimental. MÉTODO: foram avaliadas 26 cobaias albinas através das EOAPD pré e pós-tratamento com gentamicina. Para a avaliação anatômica por MEV, as cobaias foram sacrificadas em tempo programado após a administração das drogas via intramuscular. RESULTADOS: a avaliação do estado funcional das CCE mostrou preservação das OEAPD em todas as cobaias. Os resultados da MEV, depois de fotografados foram analisados através da contagem do número de CCE da espira basal da cóclea em determinado campo fotográfico. CONCLUSÃO: não foram observadas lesões ou alterações no funcionamento das células ciliadas externas mediante a dosagem aplicada em cobaias albinas, de 4mg/Kg/dia (dose única) e 2,5mg/Kg/dia a cada 12 horas, utilizadas por 10 e 14 dias.

Evaluation of aminoglycosides [gentamicin, neomycin, streptomycin] and fluoroquinolones [ofloxacin] antibiotics on spermatogenesis in rat

Gentamicin, Neomycin, Streptomycin and ofloxacin are synthetic antibacterial agent belonging to the family of aminoglycoside and fluoroquinolones antibiotics with a very broad spectrum against microbial pathogens, especially Gram-negative and urinary tract infectious diseases which nowadays have good effect in diseases treatment in more countries world-wide. The aim of this study was to see the effects of this drugs inducement, in Spermatogenesis cycle in rat. The fifty male wistar rat were selected and randomly divided into five groups; control [n=10] and test [n=40]. The test groups was received 5mg/kg [IP] Gentamicin, 50mg/kg [IP] Neomycin, 40mg/kg [IP] Streptomycin, and 72mg/kg [PO] ofloxacin daily for fourteenth day; however the control group just received vehicle [IP]. In fourteenth day the testis tissue of Rat in whole groups were removed and sperm was collected from epididymis then prepared for analysis. Light microsopic Obervation Showed that sperm cell count and viability as compared with compared with control group decreased significantly [p<0.001]. When compared with control group, percentage of sperm motility decreased significantly in all experimental except ofloxacin group [p>0.05]. Since in our study ofioxacin had only effect on sperm population and viability and hadn't any effect on sperm motility percentage, so it seems that using this antibiotic is safest more than others on sperm health parmeters

Increased expression of p38 mitogen- activated protein kinase is related to the acute renal lesions induced by gentamicin

Mitogen-activated protein kinases (MAPK) may be involved in the pathogenesis of acute renal failure. This study investigated the expression of p-p38 MAPK and nuclear factor kappa B (NF-kappaB) in the renal cortex of rats treated with gentamicin. Twenty rats were injected with gentamicin, 40 mg/kg, im, twice a day for 9 days, 20 with gentamicin + pyrrolidine dithiocarbamate (PDTC, an NF-kappaB inhibitor), 14 with 0.15 M NaCl, im, twice a day for 9 days, and 14 with 0.15 M NaCl , im, twice a day for 9 days and PDTC, 50 mg kg-1 day-1, ip, twice a day for 15 days. The animals were killed 5 and 30 days after the last of the injections and the kidneys were removed for histological, immunohistochemical and Western blot analysis and for nitrate determination. The results of the immunohistochemical study were evaluated by counting the p-p38 MAPK-positive cells per area of renal cortex measuring 0.05 mm². Creatinine was measured by the Jaffé method in blood samples collected 5 and 30 days after the end of the treatments. Gentamicin-treated rats presented a transitory increase in plasma creatinine levels. In addition, animals killed 5 days after the end of gentamicin treatment presented acute tubular necrosis and increased nitrate levels in the renal cortex. Increased expression of p-p38 MAPK and NF-kappaB was also observed in the kidneys from these animals. The animals killed 30 days after gentamicin treatment showed residual areas of interstitial fibrosis in the renal cortex, although the expression of p-p38 MAPK in their kidneys did not differ from control. Treatment with PDTC reduced the functional and structural changes induced by gentamicin as well as the expression of p-p38 MAPK and NF-kappaB. The increased expression of p-p38 MAPK and NF-kappaB observed in these rats suggests that these signaling molecules may be involved in the pathogenesis of tubulointerstitial nephritis induced by gentamicin.

Influence of gentaminice on the pharmacokinetic of a pentavalent antimonial compound glucantime influence of gentaminice on glucantime kinetic

Se estudiaron los parámetros farmacocinéticos del antimoniato de meglumina Glucantime® después de su administración solo y en combinación con gentamicina, a objeto de determinar el efecto del aminoglucósido sobre las concentraciones plasmáticas y los parámetros farmacocinéticos del metal. Se inyectaron cuatro perros con una dosis única/día de Glucantime® (25.65 mgkg-1) durante 5 días y Glucantime® + gentamicine (25.65 mg kg-1 y 5 mg kg-1, respectivamente). Se colectaron muestras de sangre 0.25, 0.75, 1.0, 2.0, 4.0, 8.0, 12.0 y 24.0 horas post-tratamiento. Las determinaciones de antimonio se realizaron usando espectroscopia de absorción atómica. Los resultados demuestran que la combinación modificó la depuración del metal y disminuyó sus concentraciones plasmáticas. Solo ClB mostró una diferencia significativa (0.353 ± 0.110 a 0.733 ± 0.33 mLh-1kg-1), sugiriendo menor persistencia tisular con la administración conjunta. En el futuro debe aclararse si la gentamicina interfiere en el análisis de las concentraciones de antimonio o viceversa.

Combined effects of noise and gentamicin on hearing in the guinea pig.

The last ten years, the use of gentamicin has increased due to antibiotic resistance among bacterial pathogens. One of the side effects of gentamicin is its toxicity on hearing. Several authors had even pointed out synergistic effects of gentamicin and noise on hearing. It was therefore reasonable to think that the damaging effects of noise could be emphasized by a gentamicin treatment of the subjects. In order to test the applicability of the Leq8h for estimating the hazard of noise on animals treated with a non-ototoxic dose of gentamicin (40 mg/kg for 8 days), two experiments were carried out with guinea pigs. The animals were exposed to octave band noises centred at 8 kHz and treated with gentamicin either simultaneously or sequentially with regard to the noise exposure. Two noise exposures having different acoustic energy, respectively Leq8h = 85 dB and 98.8 dB SPL, were tested. The auditory function of the guinea pigs was tested by recording auditory-evoked potentials. The electrophysiological findings were completed by histological data. The gentamicin treatment tested in the current studies did not cause any auditory permanent threshold shift neither cochlear disruptions, although the treatment could be considered as approximately ten times the therapeutic dose used in human. The auditory deficit induced by the mixed exposures to noise and gentamicin did not worsen the noise effect alone in our experimental conditions. As a result, the European value recommended for noise exposure (Leq8h=85 dB) seems to be robust enough to protect gentamicin-treated workers.

Protective role of vitamin B6 in Gentamicin Nerphrotoxicity

The use of gentamicin in daily clinical practice is very common. It's well known toxic side effect is mainly on kidneys. This antibiotic causes lipid peroxidation as an ultimate event in its nephrotoxic effect, which explains why Gentamicin induced nephrotoxicity is not affected by many powerful antioxidants like vita A., C., and E. and when tried with agents like Nitrendipine also. Gentamicin toxic effect elicits itself as an acute renal cortical tubular necrosis. It has recently been established that in rabbits, there occurs a decrease in pyridoxal 5 phosphate [a coenzyme of Vitamin B6] levels when gentamicin is given even in therapeutic doses. The present study was, therefore, designed as an endeavor to ascertain and establish the role [if any] of vitamin B6 supplementation for the protection/elimination of the nephrotoxic effect of gentamicin. For this purpose, 28 male albino rats were used by making four groups with seven animals in each. Group A, kept as control Group. B given vit. B6, group C administered Gentamicin and D group given Gentamicin + B6, I/P, daily for 10 consective days. Animals were sacrificed after 10 days, their kidneys were removed, divided, fixed and evaluated structurally at histological levels under light microscope. The morphological changes in the structure of kidneys of group C animals [nephrotoxic group] were analyzed and compared with other groups i.e. A,B and D to reach the conclusion that the renal toxicity produced by Gentamicin could be inhibited effectively by simultaneous vitamin B6 treatment

Interferência do intervalo de administração da droga sobre a nefrotoxicidade da gentamicina em ratos / Influence of the dose regimen on the gentamicin nephrotoxicity in rats

A insuficiência renal aguda (IRA) que apresenta índice de mortalidade em torno de 50 por cento, pode ser definida como um abrupto declínio da filtração glomerular, resultante de isquemia ou toxicidade. A nefrotoxicidade por drogas é uma das etiologias mais freqüentes (27 por cento) e sugere-se que o intervalo de administração da droga pode interferir neste efeito colateral, entretanto o melhor regime de administração ainda não está bem estabelecido. Este conhecimento proporcionaria uma atuação mais direcionada de enfermagem na prevenção desta IRA hospitalar. Os resultados obtidos nesta pesquisa, indicam que a infusão única de gentamicina determina menor nefrotoxicidade, provavelmente devido à redução da sua concentração plasmática nas 24hs, diminuindo o acúmulo intracelular deste fármaco, um dos principais mecanismos celulares deste tipo de lesão. Este regime de tratamento mostra portanto vantagens quanto ao custo, efeito nefrotóxico e segurança quanto à eficácia terapêutica.

The acute renal failure (ARF), that still presents a righ mortality rate (50 percent) can be defined as an abrupt decline of the glomerular filtration, resultant of isquemic or toxicity event. The drugs nephrotoxicity is one of the most frequent cause (27 percent) of ARF and it is suggested that the interval of administration of the drug can interfere in this side effect, however the best administration regimen is not very well established. This study evaluated the renal function of rats that received gentamicin (100mg/kg) in one dose or in two doses (2x 50mg/kg),by intraperitoneal infusion. The results obtained in this research, indicated that the single infusion of gentamicin determined smaller nephrotoxicity by the reduction of serum concentration of this drug in 24 hours, decreasing the intracelular accumulation of this gentamicin, which is one of the main cellular mechanisms of this renal injury. The single dose treatment regime, otherwise, showes advantages not only related to the nephrotoxicity effect, but also it is relevant to the cost and safety, which can be rationable factors in the administration of this drug.

Histological effects of gentamicin intake during pregnancy on the liver and kidney of the fetus and mother of albino rat

Gentamicin is an aminoglycoside antibiotic which is widely used in the treatment of Gram-negative bacterial infections. The aim of this study is to demonstrate its effects not only on the liver and kidney of the pregnant female but also to show its effects on the developing liver and kidney of the fetus. In this work, a total of 40 albino rats were used. Twenty animals used as control groups for the mothers and fetuses. The other twenty were used as treated groups with gentamicin for the mothers and fetuses. Gentamicin in a dose of 100 mg / kg / day was given subcutaneously to the albino rats. The treatment was continuous for six days strating form 15-21 day of pregnancy. After that, the mothers and their fetuses were sacrified. Specimens of kidney and liver of some animals were processed and embedded in paraffin for routine histological examination after staining with Hematoxylin and Eosin. Liver and Kidney specimens of other animals were prepared for ultrastructural study. The mother kidney shows areas of focal hemorrhage with degeneration of the proximal convoluted tubules. The fetal kidney shows increase in the immature renal corpuscles. It also shows focal areas of tubular dilation with disruption of their lining epithelium. The mother liver shows distorted hepatic architecture. The blood sinusoids and bile ducts are dilated. There is also centrilobular inflammatory cellular infiltration. The fetal liver cells have vacuolated cytoplasm with a lot of lysosomes. From the findings observed in the present work, it xould be concluded that Gentamicin is the antibodies which had adverse reactions to the kidney and liver of both mother and fetus. It is thus recommended that it should be used with caution during pregnancy and only for strong clinical indications in the absence of suitable alternative

Study of some renal functions after calcium and calcium channel blockers in normal and gentamycin-treated rats

Gentamycin nephrotoxicity occurs in a substantial proportion of patients receiving this drug. Animal studies have shown that dietary calcium diminishes the severity of this renal damage. Thus, the aim of the present work was to demonstrate the effect of Ca[+2] and Ca[+2] channel blocker verapamil on some renal functions in rats. 60 adult male albino rats were divided into six groups serving as control, verapamil-treated, gentamycin-treated, verapamil-gentamycin treated, given excess Ca[+2] alone, and lastly those receiving gentamycin with excess Ca[+2] in diet. Serum Na[+], K[+], creatinine clearance and Na+K+-ATPase activity in kidney tissue homogenate were determined 48 hours after last injection. There were impaired renal functions after treatment with gentamycin and was manifested by hypokalaemia, decreased creatinine clearance and Na[+] K[+]ATPase activity. These effects were more severe in rats treated with combined gentamycin and verapamil than gentamycin alone. Also, high dietary Ca[+] reduced gentamycin nephrotoxicity. This indicates that verapamil increases the severity of gentamycin nephrotoxicity as it inhibits mobilization of Ca[+2] across cellular and intracellular membranes