(3) Renal function impairment with nitrogen retention and proteinuria can
occur during kanamycin therapy, especially in clients with pre-existing kidney damage.
(4) Neuromuscular paralysis with respiratory depression has been reported
following parenteral or intraperitoneal administration.
e. Supply. Kanamycin sulfate injection, 37.5-mg/ml for pediatric use, is
supplied in 2-ml units. The preparation for adult use, 333-mg/ml, is supplied in 3-ml
a. Gentamicin sulfate (Garamicin) has the same general uses and warnings as
kanamycin (above). It is effective against most strains of staphylococci, E. coli,
Klebsiella, Enterobacter, and Pseudomonas aeruginosa, and many strains of Proteus
b. The concomitant use of carbenicillin (a penicillin) with gentamicin may result
in synergistic activity against some strains of Pseudomonas and may allow for lower
doses of gentamicin to be used.
c. Gentamicin is not considered the drug of choice for treating gram-negative
sepsis because of susceptible organisms.
d. It is available as gentamicin sulfate cream (1-mg of gentamicin per gram) and
as gentamicin sulfate injection (40-mg/ml) in a 2-ml bottle for intramuscular use.
Neomycin is very similar to kanamycin, as discussed above, but it is usually
restricted to topical applications and to oral use for reduction of microbes in the gut
before surgery. It has a wide range of activity; it is effective against both gram-negative
and gram- positive bacteria. It is useful in many local infections, including burns,
wounds, ulcers, and other sites of infection. However, Pseudomonas species and
streptococci tend to be resistant.
Neomycin is often combined with the narrow-spectrum antibiotic bacitracin.
Bacitracin (not an aminoglycoside) is especially effective against gram-
positive organisms. It too is usually confined to topical use. It is often
effective in the treatment of infections associated with wounds, carbuncles,
superficial and deep abscesses, and infected ulcers. It is available alone in
bacitracin ointment and bacitracin ophthalmic ointment.
a. Neomycin Sulfate. Neomycin sulfate is available alone in a powder and in