Be careful with the toxicity of the antibiotic kanamycin

If tinnitus or ototoxicity occurs, the dose of kanamycin should be reduced or discontinued.

Kanamycin is an aminoglycoside antibiotic, used for short-term treatment of serious infections caused by susceptible strains of bacteria (such as E. coli, Proteus, Enterobacter aerogenes, Klebsiella pneumoniae, Serratia marcescens and Mima-Herella) that are resistant to other aminoglycosides; Treatment of gonorrhea and gonococcal ophthalmia neonatorum. Like gentamicin, in severe infections, when necessary, kanamycin can be used with penicillin or cephalosporin, but should be avoided when there is ototoxicity and nephrotoxicity. Kanamycin is also used as a second-line drug in the treatment of tuberculosis, but nowadays other safer drugs are often used.

Do not use the drug in patients with a history of hypersensitivity or toxic reactions to kanamycin or other aminoglycosides. In cases of impaired renal function, the kidneys cannot effectively eliminate kanamycin and the concentration of kanamycin in the serum increases rapidly, the dose must be reduced to avoid toxicity. Kanamycin must always be used with caution and should only be used in cases of severe or drug-resistant infections caused by bacteria that are resistant to other antibiotics but are still sensitive to kanamycin.

If tinnitus or ototoxicity occurs, the dose of kanamycin should be reduced or discontinued. Illustration photo

Kanamycin should be used with caution in patients with myasthenia gravis because kanamycin has some curare-like activity. There have been a few cases of respiratory arrest or failure following intraperitoneal administration of kanamycin. In addition, sensory and motor neuropathy has occurred with topical use of kanamycin during spinal surgery. Kanamycin slightly reduces muscle tone in patients with myasthenia gravis, so intraperitoneal administration should not be used in patients who have received neuromuscular blocking agents during surgery.

Do not use the drug for pregnant women. For breastfeeding women, kanamycin is excreted in milk. No effect on breastfed infants has been observed, because kanamycin is poorly absorbed orally. However, there are 3 issues that need to be noted for breastfed infants: the drug changes the intestinal microflora, directly affects the child (allergy or hypersensitivity) and distorts the results of bacterial culture when there is a fever that requires this test.

Illustration photo (Internet source)

As with other aminoglycosides, the most important adverse reactions of kanamycin are ototoxicity (after prolonged use the frequency of this reaction is about 40%), neuromuscular blockade, hypersensitivity reactions and nephrotoxicity. Ototoxicity is increased when kanamycin or other aminoglycosides are combined with vancomycin. If tinnitus or other signs of ototoxicity appear, the dose of kanamycin must be reduced or discontinued. In addition, the drug also causes vestibular toxicity (occurring in less than 10% of cases treated with normal doses) and is usually reversible after discontinuation of the drug.

According to Dr. Hoang Thu Thuy - Health & Life - NT