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April 11, 1977

10. Parenteral Aminoglycosides: Veterans Administration Ad Hoc Interdisciplinary Advisory Committee on Antimicrobial Drug Usage

JAMA. 1977;237(15):1607-1608. doi:10.1001/jama.1977.03270420075025

PARENTERAL aminoglycosides (gentamicin sulfate, tobramycin sulfate, kanamycin sulfate, and amikacin sulfate) are among the most valuable drugs currently available for the treatment of serious, life-threatening infections caused by enteric Gram-negative bacteria. They are relatively expensive and may produce ototoxicity and nephrotoxicity. Additionally, bacterial strains resistant to these drugs have emerged in recent years, particularly Pseudomonas, Proteus (rettgeri), Providencia, and Serratia. For these reasons, there must be clear-cut indications for their use, particularly when less expensive, less toxic agents may work as well. It is strongly urged that each hospital select a single agent, preferably gentamicin sulfate or tobramycin sulfate, for primary use. The other agents should be held in reserve for treatment of patients with infections caused by resistant organisms. This may be accomplished by performance of sensitivity testing against the organisms cited here and reporting results for the aminoglycosides held in reserve only when resistance is encountered to the