Comparative Pharmacology
Head-to-head clinical analysis: KANAMYCIN versus NEOMYCIN AND POLYMYXIN B SULFATES AND GRAMICIDIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: KANAMYCIN versus NEOMYCIN AND POLYMYXIN B SULFATES AND GRAMICIDIN.
KANAMYCIN vs NEOMYCIN AND POLYMYXIN B SULFATES AND GRAMICIDIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Aminoglycoside antibiotic that irreversibly binds to the 30S ribosomal subunit, causing misreading of mRNA and inhibiting protein synthesis.
Neomycin and gramicidin are aminoglycoside and polypeptide antibiotics, respectively, that inhibit bacterial protein synthesis by binding to the 30S and 50S ribosomal subunits, while polymyxin B is a cationic detergent that disrupts bacterial cell membrane integrity by binding to lipopolysaccharides.
15 mg/kg/day IM or IV in divided doses every 12 hours. Maximum daily dose: 1.5 g.
1-2 drops or a small amount applied to affected eye(s) every 4 hours, or more frequently if severe, for up to 7-10 days. Ophthalmic ointment: apply a 1/2-inch ribbon into conjunctival sac every 3-4 hours.
None Documented
None Documented
Clinical Note
moderateKanamycin + Digoxin
"The serum concentration of Digoxin can be decreased when it is combined with Kanamycin."
Clinical Note
moderateKanamycin + Digitoxin
"The serum concentration of Digitoxin can be decreased when it is combined with Kanamycin."
Clinical Note
moderateKanamycin + Deslanoside
"The serum concentration of Deslanoside can be decreased when it is combined with Kanamycin."
Clinical Note
moderateKanamycin + Acetyldigitoxin
Terminal elimination half-life is 2-4 hours in patients with normal renal function (creatinine clearance >80 mL/min). In anuria, half-life may extend to 50-100 hours, necessitating dose adjustment based on renal function.
Neomycin: plasma half-life ~2-3 hours in patients with normal renal function, but can extend to 12-24 hours or more in renal impairment. Polymyxin B: half-life ~6 hours in normal renal function, prolonged significantly in renal failure (up to 2-3 days). Gramicidin: not systemically absorbed; half-life not applicable.
Primarily renal excretion via glomerular filtration; approximately 80-90% of administered dose is excreted unchanged in urine within 24 hours. Biliary/fecal excretion is minimal (<1%).
Neomycin and polymyxin B sulfates and gramicidin are poorly absorbed from intact skin or ophthalmic sites. After topical application, absorbed neomycin is excreted primarily unchanged in urine (30-50% of absorbed dose) via glomerular filtration; polymyxin B is excreted slowly via renal tubular secretion and glomerular filtration (60-70% of absorbed dose in urine); fecal elimination accounts for minor amounts. Gramicidin is not significantly absorbed.
Category C
Category A/B
Aminoglycoside Antibiotic
Aminoglycoside Antibiotic
"The serum concentration of Acetyldigitoxin can be decreased when it is combined with Kanamycin."